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中国临床药理学与治疗学 ›› 2020, Vol. 25 ›› Issue (9): 1007-1013.doi: 10.12092/j.issn.1009-2501.2020.09.007

• 临床药理学 • 上一篇    下一篇

阳性拓展临床试验的统计

谢蒙生,赵杨,陈峰
  

  1. 南京医科大学公共卫生学院,南京 211166,江苏

  • 收稿日期:2020-04-28 修回日期:2020-05-25 出版日期:2020-09-26 发布日期:2020-09-30
  • 通讯作者: 陈峰,男,博士,教授,博士生导师,研究方向:临床试验中的统计方法。 Tel: 025-86869230 E-mail: fengchen@njmu.edu.cn 赵杨,男,博士,教授,硕士生导师,研究方向:复杂生物医学数据整合分析及因果推断方法研究。 Tel: 025-86868436 E-mail: yzhao@njmu.edu.cn
  • 作者简介:谢蒙生,男,硕士研究生,研究方向:生物统计。 Tel: 021-68825798 E-mail: henrydamo@126.com
  • 基金资助:
    国家自然科学基金(81872709);江苏省青蓝工程学科带头人;南京医科大学中青年教师支持计划

Statistical analysis of active extension trial

XIE Mengsheng, ZHAO Yang, CHEN Feng   

  1. School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China
  • Received:2020-04-28 Revised:2020-05-25 Online:2020-09-26 Published:2020-09-30

摘要: 目的:结合随机撤除试验的阳性拓展试验,对试验药物疗效的估计方法进行研究,并研究受试者停药后的反跳现象。方法:本文分别采用只利用第一阶段数据的传统方法和结合阳性拓展阶段数据的方法对试验药物的短期疗效进行估计,进一步估计长短期疗效间的差异和停药后的疗效差异,并运用模拟试验比较利用不同阶段数据来估计短期疗效各方法的优劣。结果:结合阳性拓展数据估计的疗效的标准误(0.17)小于仅使用第一阶段数据的传统方法的估计的标准误(0.19),特别是对于疗效能在短期稳定的药物,此方法的把握度更高。结论:基于传统方法只使用了第一阶段的数据,而结合阳性拓展阶段数据的方法考虑了第二、三阶段的数据,充分利用了信息,使效应估计值的标准误有所降低,提高了参数估计的有效性,但此种方法基于较强假设,治疗达到稳定疗效所需的时间会对结果有所影响。

关键词: 阳性拓展, 临床试验, 重复测量

Abstract: AIM: To estimate the treatment effect before and after patients stopped taking the drug, based on the combination of withdrawal randomized study and active extension trial design. METHODS: The short term treatment effect was estimated separately by the traditional method of using first stage data and the method of taking second or third stage data into consideration. And the treatment difference between long term and short term, also the treatment difference after patients discontinued from treatment were further assessed. The robustness of the result was tested by simulation assumed different scenario. RESULTS: The standard error (0.17) of the treatment effect estimation used more stage data was less than that of only used the first stage (Standard error: 0.19), besides much powerful for those treatment effect could be stabilized in the short period. CONCLUSION: Compared with the method only utilized the data of the first stage, the method developed here utilized second or third stage data. The utilization of more information leaded to decreasing of standard deviation and increasing of validity for the estimation of treatment effect. But the results will be influenced by the time required for the stabilization of the treatment effect, since the method was based on certain assumptions.

Key words: active extension trail, clinical trail, repeated measurements

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