Summarizing adverse event risk
A. Lawrence Gould
Merck Research Laboratories, 770 Sumneytown Pike, West Point, PA 19486, USA
Search for more papers by this authorA. Lawrence Gould
Merck Research Laboratories, 770 Sumneytown Pike, West Point, PA 19486, USA
Search for more papers by this authorA. Lawrence Gould
Merck Research Laboratories, 770 Sumneytown Pike, West Point, PA 19486, USA
Search for more papers by this authorSummary
The analysis of adverse event frequency from clinical development projects includes summarization of important features of the occurrence of adverse events such as how often they occur, when they emerge, how often they recur, and how severely they are manifested. Comparisons of risks among treatment groups are essential for this evaluation, particularly as expressed by confidence or credible intervals for measures of difference between or relative risk of adverse event occurrences among treatment groups. This chapter describes some means for summarizing and getting an understanding of the adverse event profile of the treatments in clinical development programs, most usually clinical trials. Typical examples include survival-type analysis for adverse event emergence and recurrence, and various regression modeling strategies for identifying potential predictors of adverse event occurrence other than assigned treatment. The chapter describes a Bayesian screening method that adjusts for the potential multiplicity issue that arises when many events occur.
References
- Agresti, A. and Min, Y. (2005) Frequentist performance of Bayesian confidence intervals for comparing proportions in 2 × 2 contingency tables. Biometrics, 61, 515–523.
- Brown, L. and Li, X. (2005) Confidence intervals for two sample binomial distributions. Journal of Statistical Planning and Inference, 130, 359–375.
- Fagerland, M.W., Lydersen, S. and Laake, P. (2011) Recommended confidence intervals for two independent binomial proportions. Statistical Methods in Medical Research. doi: 10.1177/0962280211415469
- Fagerland, M.W. and Newcombe, R.G. (2013) Confidence intervals for odds ratio and relative risk based on the inverse hyperbolic sine transformation. Statistics in Medicine, 32, 2823–2836.
- Farrington, C.P. and Manning, G. (1990) Test statistics and sample size formulae for comparative binomial trials with null hypothesis of non-zero risk difference or non-unity relative risk. Statistics in Medicine, 9, 1454.
-
Newcombe, R. G. Interval estimation for the difference between independent proportions: Comparison of eleven methods, Statistics in Medicine, 17, 873–890 (1998). Corrigendum 18, 1293 (1989)
10.1002/(SICI)1097-0258(19980430)17:8<873::AID-SIM779>3.0.CO;2-I CAS PubMed Web of Science® Google Scholar
- Newcombe, R.G. and Nurminen, M. (2011) In defence of score intervals for proportions and their differences. Communications in Statistics – Theory and Methods, 40, 1271–1282.
- Santner, T.J., Pradhan, V., Senchaudhuri, P. et al. (2007) Small-sample comparisons of confidence intervals for the difference of two independent binomial proportions. Computational Statistics and Data Analysis, 51, 5791–5799.
- Zhang, H., Gutiérrez Rojas, H.A. and Cepeda Cuervo, E. (2010) Confidence and credibility intervals for the difference of two proportions. Revista Colombiana de Estadística, 33, 63–88.
- Hamilton, M.A. (1979) Choosing the parameter for a 2 × 2 table or a 2 × 2 × 2 table analysis. American Journal of Epidemiology, 109, 362–375.
- Agresti, A. and Min, Y.Y. (2002) Unconditional small-sample confidence intervals for the odds ratio. Biostatistics, 3, 379–386.
- Lydersen, S., Fagerland, M.W. and Laake, P. (2009) Recommended tests for association in 2 × 2 tables. Statistics in Medicine, 28, 1159–1175.
- Mehrotra, D.V., Chan, I.S.F. and Berger, R.L. (2003) A cautionary note on exact unconditional inference for a difference between two independent binomial proportions. Biometrics, 59, 441–450.
- Krishnamoorthy, K. and Lee, M. (2010) Inference for functions of parameters in discrete distributions based on fiducial approach: binomial and Poisson cases. Journal of Statistical Planning and Inference, 140, 1182–1192.
- Mee, R.W. (1984) Confidence bounds for the difference between two probabilities (letter). Biometrics, 40, 1175–1176.
- Miettinen, O. and Nurminen, M. (1985) Comparative analysis of two rates. Statistics in Medicine, 4, 213–226.
- R Development Core Team. R: A Language and Environment for Statistical Computing, R Development Core Team, Vienna, http://www.R-project.org (accessed 24 June 2014).
- Wilson, E.B. (1927) Probable inference, the law of succession, and statistical inference. Journal of the American Statistical Association, 22, 209–212.
- Agresti, A. and Caffo, B. (2000) Simple and effective confidence intervals for proportions and differences of proportions result from adding two success and two failures. Annals of Statistics, 54, 280–288.
- Koopman, P.A.R. (1984) Confidence limits for the ratio of two binomial proportions. Biometrics, 40, 513–517.
- Nam, J. (1995) Confidence limits for the ratio of two binomial proportions based on likelihood scores. Biometrical Journal, 37, 375–379.
- Gart, J.J. and Nam, J. (1988) Approximate interval estimation of the ratio of binomial parameters: a review and correction for skewness. Biometrics, 44, 323–338.
- Aitchison, J. and Bacon-Shone, J. (1981) Bayesian risk ratio analysis. American Statistician, 35, 254–257.
- Gould, A.L. (1988) Applications of interval inference, in Biopharmaceutical Statistics for Drug Development (ed K.E. Peace), Marcel Dekker, New York, pp. 509–541.
-
Baptista, J. and Pike, M.C. (1977) Exact two-sided confidence limits for the odds ratio in a 2 x 2 table. Applied Statistics, 26, 214–220.
10.2307/2347041 Google Scholar
- Liao, J.G. and Rosen, O. (2001) Fast and stable algorithms for computing and sampling from the noncentral hypergeometric distribution. American Statistician, 55, 366–369.
- Mehrotra, D.V. and Heyse, J.F. (2004) Use of the false discovery rate for evaluating clinical safety data. Statistical Methods in Medical Research, 13, 227–238.
- Li, H.-Q., Tang, M.L., Poon, W.-Y. and Tang, N.-S. (2011) Confidence intervals for difference between two Poisson rates. Communications in Statistics – Simulation and Computation, 40, 1478–1493.
- Zou, G.Y. and Donner, A. (2008) Construction of confidence limits about effect measures. A general approach. Statistics in Medicine, 27, 1693–1702.
- Byrne, J. and Kabila, P. (2005) Comparison of Poisson confidence intervals. Communications in Statistics-Theory and Methods, 34, 545–556.
- Brown, L.D., Cai, T. and DasGupta, A. (2001) Interval estimation for a binomial proportion (with discussion). Statistical Science, 16, 101–133.
- Graham, P.L., Mengersen, K. and Morton, A.P. (2003) Confidence limits for the ratio of two rates based on likelihood scores: non-iterative method. Statistics in Medicine, 22, 2071–2083.
- Berry, S.M. and Berry, D.A. (2004) Accounting for multiplicities in assessing drug safety: a three-level hierarchical mixture model. Biometrics, 60, 418–426.
- Gould, A.L. (2008) Detecting potential safety issues in clinical trials by Bayesian screening. Biometrical Journal, 50, 837–851.
- Gould, A.L. (2013) Detecting potential safety issues in large clinical or observational trials by Bayesian screening when event counts arise from Poisson distributions. Journal of Biopharmaceutical Statistics, 23, 829–847.
- ICH Expert Working Group (1998) Statistical Principles for Clinical Trials E9, http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Efficacy/E9/Step4/E9_Guideline.pdf (accessed 29 October 2007).
- Scott, J.G. and Berger, J.O. (2010) Bayes and empirical-Bayes multiplicity adjustment in the variable-selection problem. Annals of Statistics, 38, 2587–2619.