scholarly journals What to make of equivalence testing with a post-specified margin?

2021 ◽  
Vol 5 ◽  
Author(s):  
Harlan Campbell ◽  
Paul Gustafson
Keyword(s):  
Clinical Trials ◽  
Statistical Test ◽  
Critical Discussion ◽  
Equivalence Testing ◽  
Equivalence Test ◽  
Short Article ◽  
Equivalence Tests ◽  
Post Hoc ◽  
Equivalence Margin

In order to determine whether or not an effect is absent based on a statistical test, the recommended frequentist tool is the equivalence test. Typically, it is expected that an appropriate equivalence margin has been specified before any data are observed. Unfortunately, this can be a difficult task. If the margin is too small, then the test's power will be substantially reduced. If the margin is too large, any claims of equivalence will be meaningless. Moreover, it remains unclear how defining the margin afterwards will bias one's results. In this short article, we consider a series of hypothetical scenarios in which the margin is defined post-hoc or is otherwise considered controversial. We also review a number of relevant, potentially problematic actual studies from the clinical trials research, with the aim of motivating a critical discussion as to what is acceptable and desirable in the reporting and interpretation of equivalence tests.

scholarly journals Equivalence Testing for Regression Discontinuity Designs

2020 ◽  
pp. 1-17
Author(s):  
Erin Hartman
Keyword(s):  
Political Science ◽  
Current Practice ◽  
Regression Discontinuity ◽  
Regression Function ◽  
Superior Performance ◽  
Equivalence Testing ◽  
Simulation Studies ◽  
Equivalence Tests ◽  
Regression Discontinuity Designs ◽  
Testing Approach

Abstract Regression discontinuity (RD) designs are increasingly common in political science. They have many advantages, including a known and observable treatment assignment mechanism. The literature has emphasized the need for “falsification tests” and ways to assess the validity of the design. When implementing RD designs, researchers typically rely on two falsification tests, based on empirically testable implications of the identifying assumptions, to argue the design is credible. These tests, one for continuity in the regression function for a pretreatment covariate, and one for continuity in the density of the forcing variable, use a null of no difference in the parameter of interest at the discontinuity. Common practice can, incorrectly, conflate a failure to reject evidence of a flawed design with evidence that the design is credible. The well-known equivalence testing approach addresses these problems, but how to implement equivalence tests in the RD framework is not straightforward. This paper develops two equivalence tests tailored for RD designs that allow researchers to provide statistical evidence that the design is credible. Simulation studies show the superior performance of equivalence-based tests over tests-of-difference, as used in current practice. The tests are applied to the close elections RD data presented in Eggers et al. (2015b).

scholarly journals Disability improvement as a clinically relevant outcome in clinical trials of relapsing forms of multiple sclerosis

2021 ◽  
pp. 135245852110002
Author(s):  
Bruce AC Cree ◽  
Jeffrey A Cohen ◽  
Anthony T Reder ◽  
Davorka Tomic ◽  
Diego Silva ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Trials ◽  
Therapeutic Benefit ◽  
Disease Modifying Therapies ◽  
Long Term Follow Up ◽  
Post Hoc ◽  
Switch Group ◽  
Relevant Outcome

Background: Disease-modifying therapies (DMTs) can reduce the risk of disability worsening in patients with relapsing forms of multiple sclerosis (RMS). High-efficacy DMTs can lead to confirmed or sustained disability improvement (CDI and SDI). Objective and Methods: Post hoc analyses of data from the TRANSFORMS, FREEDOMS, and FREEDOMS II trials and their extensions assessed the effects of fingolimod (0.5–1.25 mg/day) on stabilizing or improving disability over ⩽8 years in participants with RMS. CDI and SDI rates were compared between participants initially randomized to fingolimod, interferon (IFNβ-1a), or placebo. Results: At 8 years’ follow-up in TRANSFORMS, 35.1% (95% confidence interval [CI], 28.2%–43.1%) of assessed participants in the IFNβ-1a–fingolimod switch group and 41.9% (36.6%–47.6%) on continuous fingolimod experienced CDI; disability did not worsen in approximately 70%. Similar results were seen in the combined FREEDOMS population. Proportionally fewer TRANSFORMS participants achieved SDI in the IFNβ-1a–fingolimod switch group than on continuous fingolimod (5.4% [3.0%–9.5%] vs 14.2% [10.8%–18.4%], p = 0.01). Conclusion: CDI and SDI are outcomes of interest for clinical trials and for long-term follow-up of participants with RMS. Monitoring CDI and SDI in addition to disability worsening may facilitate understanding of the therapeutic benefit of RMS treatments.

scholarly journals MET: a Java package for fast molecule equivalence testing

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Jördis-Ann Schüler ◽  
Steffen Rechner ◽  
Matthias Müller-Hannemann
Keyword(s):  
Chemical Properties ◽  
Graph Isomorphism ◽  
Isomorphism Problem ◽  
Equivalence Classes ◽  
Equivalence Testing ◽  
Equivalence Test ◽  
Graph Isomorphism Problem ◽  
2D Structure ◽  
Node Labels ◽  
Labelled Graphs

AbstractAn important task in cheminformatics is to test whether two molecules are equivalent with respect to their 2D structure. Mathematically, this amounts to solving the graph isomorphism problem for labelled graphs. In this paper, we present an approach which exploits chemical properties and the local neighbourhood of atoms to define highly distinctive node labels. These characteristic labels are the key for clever partitioning molecules into molecule equivalence classes and an effective equivalence test. Based on extensive computational experiments, we show that our algorithm is significantly faster than existing implementations within , and . We provide our Java implementation as an easy-to-use, open-source package (via GitHub) which is compatible with . It fully supports the distinction of different isotopes and molecules with radicals.

scholarly journals Onset and Resolution of Key Adverse Events in Valbenazine-Treated Patients with Tardive Dyskinesia: Pooled Analyses from Two Long-Term Clinical Trials

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 151-151
Author(s):  
Stephen R. Marder ◽  
Jean-Pierre Lindenmayer ◽  
Chirag Shah ◽  
Tara Carmack ◽  
Angel S. Angelov ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Adverse Events ◽  
Tardive Dyskinesia ◽  
Suicidal Behavior ◽  
Prolonged Exposure ◽  
First Occurrence ◽  
Balance Disorder ◽  
Clinical Interest ◽  
Post Hoc

AbstractObjectiveTardive dyskinesia (TD) is a persistent and potentially disabling movement disorder associated with prolonged exposure to antipsychotics and other dopamine receptor blocking agents. Long-term safety of the approved TD medication, valbenazine, was demonstrated in 2 clinical trials (KINECT 3 [NCT02274558], KINECT 4 [NCT02405091]). Data from these trials were analyzed post hoc to evaluate the onset and resolution of adverse events (AEs).MethodsParticipants in KINECT 3 and KINECT 4 received up to 48 weeks of once-daily valbenazine (40 or 80 mg). Data from these studies were pooled and analyzed to assess the incidence, time to first occurrence, and resolution for the following AEs of potential clinical interest: akathisia, balance disorder, dizziness, parkinsonism, somnolence/sedation, suicidal behavior/ideation, and tremor.ResultsIn the pooled population (N=314), all AEs of potential clinical interest occurred in <10% of participants, with somnolence (9.6%), suicidal behavior/ideation (6.4%), and dizziness (5.7%) being the most common AEs. Mean time to first occurrence ranged from 36 days (akathisia [n=9]) to 224 days (parkinsonism [n=2]). By end of study (or last study visit), resolution of AEs was as follows: 100% (suicidal ideation/behavior, parkinsonism); >85% (somnolence/sedation, dizziness); >70% (akathisia, balance disorder, tremor).ConclusionsIn long-term clinical trials, the incidence of AEs of potential clinical interest was low (<10%) and most were resolved by end of treatment (>70–100%). All patients taking valbenazine should be routinely monitored for AEs, particularly those that may exacerbate the motor symptoms associated with TD.FundingNeurocrine Biosciences, Inc.

scholarly journals Treatment benefit among migraine patients taking fremanezumab: results from a post hoc responder analysis of two placebo-controlled trials

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stephen D. Silberstein ◽  
Joshua M. Cohen ◽  
Ronghua Yang ◽  
Sanjay K. Gandhi ◽  
Evelyn Du ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Medication Use ◽  
Two Phase ◽  
Double Blind ◽  
Treatment Benefit ◽  
Mean Values ◽  
Treatment Benefits ◽  
Acute Headache ◽  
Post Hoc ◽  
Insight Into

Abstract Background Monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway, including the fully humanized monoclonal antibody (IgG2Δa) fremanezumab, have demonstrated safety and efficacy for migraine prevention. Clinical trials include responders and nonresponders; efficacy outcomes describe mean values across both groups and thus provide little insight into the clinical benefit in responders. Clinicians and their patients want to understand the extent of clinical improvement in patients who respond. This post hoc analysis of fremanezumab treatment attempts to answer this question: what is the benefit in subjects who responded to treatment during the two, phase 3 HALO clinical trials? Methods We included subjects with episodic migraine (EM) or chronic migraine (CM) who received fremanezumab quarterly (675 mg/placebo/placebo) or monthly (EM: 225 mg/225 mg/225 mg; CM: 675 mg/225 mg/225 mg) during the 12-week randomized, double-blind, placebo-controlled HALO EM and HALO CM clinical trials. EM and CM responders were defined as participants with a reduction of ≥ 2 or ≥ 4 monthly migraine days, respectively. Treatment benefits evaluated included reductions in monthly migraine days, acute headache medication use, and headache-related disability, and changes in health-related quality of life (HRQoL). Results Overall, 857 participants from the HALO trials were identified as responders (EM: 429 [73.8%]; CM: 428 [56.7%]). Reductions in the monthly average number of migraine days were greater among EM (quarterly: 5.4 days; monthly: 5.5 days) and CM (quarterly: 8.7 days; monthly: 9.1 days) responders compared with the overall population. The proportion of participants achieving ≥ 50% reduction in the average monthly number of migraine days was also greater in responders (EM: quarterly, 59.8%; monthly, 63.7%; CM: quarterly, 52.8%; monthly, 59.0%) than in the overall population. Greater reductions in the average number of days of acute headache medication use, greater reductions in headache-related disability scores, and larger improvements in HRQoL were observed among EM and CM responders compared with the overall populations. Conclusions Fremanezumab responders achieved clinically meaningful improvements in all outcomes. The magnitude of improvements with fremanezumab across efficacy outcomes was far greater in responders than in the overall trial population, providing insight into expected treatment benefits in participants who respond to fremanezumab in clinical practice. Trial registration ClinicalTrials.gov identifiers: NCT02629861 (HALO EM) and NCT02621931 (HALO CM).

Natural History of Patients Taking Rifaximin-α for Recurrent Hepatic Encephalopathy and Risk of Future Overt Episodes and Mortality: A Post-hoc Analysis of Clinical Trials Data

2016 ◽  
Vol 38 (5) ◽  
pp. 1081-1089.e4 ◽  
Author(s):  
Christian A. Bannister ◽  
James G. Orr ◽  
Alan V. Reynolds ◽  
Mark Hudson ◽  
Peter Conway ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Hepatic Encephalopathy ◽  
Natural History ◽  
Post Hoc Analysis ◽  
History Of ◽  
Post Hoc

scholarly journals Estimation of the correlates of protection of the rVSVΔG-ZEBOV-GP Zaire ebolavirus vaccine: a post-hoc analysis of data from phase 2/3 clinical trials

2021 ◽  
Vol 2 (2) ◽  
pp. e70-e78 ◽  
Author(s):  
Rebecca F Grais ◽  
Stephen B Kennedy ◽  
Barbara E Mahon ◽  
Sheri A Dubey ◽  
Rebecca J Grant-Klein ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Phase 2 ◽  
Post Hoc Analysis ◽  
Correlates Of Protection ◽  
Zaire Ebolavirus ◽  
Post Hoc
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