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A marginal rank-based inverse normal transformation approach to comparing multiple clinical trial endpoints.

ABSTRACT: The increase in incidence of obesity and chronic diseases and their health care costs have raised the importance of quality diet on the health policy agendas. The healthy eating index is an important measure for diet quality which consists of 12 components derived from ratios of dependent variables with distributions hard to specify, measurement errors and excessive zero observations difficult to model parametrically. Hypothesis testing involving data of such nature poses challenges because the widely used multiple comparison procedures such as Hotelling's T(2) test and Bonferroni correction may suffer from substantial loss of efficiency. We propose a marginal rank-based inverse normal transformation approach to normalizing the marginal distribution of the data before employing a multivariate test procedure. Extensive simulation was conducted to demonstrate the ability of the proposed approach to adequately control the type I error rate as well as increase the power of the test, with data particularly from non-symmetric or heavy-tailed distributions. The methods are exemplified with data from a dietary intervention study for type I diabetic children. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

SUBMITTER: Cai X

PROVIDER: S-EPMC4938741 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

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A marginal rank-based inverse normal transformation approach to comparing multiple clinical trial endpoints.

Cai Xiaoyu X Li Huiyun H Liu Aiyi A

Statistics in medicine 20160314 19

The increase in incidence of obesity and chronic diseases and their health care costs have raised the importance of quality diet on the health policy agendas. The healthy eating index is an important measure for diet quality which consists of 12 components derived from ratios of dependent variables with distributions hard to specify, measurement errors and excessive zero observations difficult to model parametrically. Hypothesis testing involving data of such nature poses challenges because the ...[more]

PMID: 26990442

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Project description:Multilevel functional data is collected in many biomedical studies. For example, in a study of the effect of Nimodipine on patients with subarachnoid hemorrhage (SAH), patients underwent multiple 4-hour treatment cycles. Within each treatment cycle, subjects' vital signs were reported every 10 minutes. This data has a natural multilevel structure with treatment cycles nested within subjects and measurements nested within cycles. Most literature on nonparametric analysis of such multilevel functional data focus on conditional approaches using functional mixed effects models. However, parameters obtained from the conditional models do not have direct interpretations as population average effects. When population effects are of interest, we may employ marginal regression models. In this work, we propose marginal approaches to fit multilevel functional data through penalized spline generalized estimating equation (penalized spline GEE). The procedure is effective for modeling multilevel correlated generalized outcomes as well as continuous outcomes without suffering from numerical difficulties. We provide a variance estimator robust to misspecification of correlation structure. We investigate the large sample properties of the penalized spline GEE estimator with multilevel continuous data and show that the asymptotics falls into two categories. In the small knots scenario, the estimated mean function is asymptotically efficient when the true correlation function is used and the asymptotic bias does not depend on the working correlation matrix. In the large knots scenario, both the asymptotic bias and variance depend on the working correlation. We propose a new method to select the smoothing parameter for penalized spline GEE based on an estimate of the asymptotic mean squared error (MSE). We conduct extensive simulation studies to examine property of the proposed estimator under different correlation structures and sensitivity of the variance estimation to the choice of smoothing parameter. Finally, we apply the methods to the SAH study to evaluate a recent debate on discontinuing the use of Nimodipine in the clinical community.

Dataset Information

A marginal rank-based inverse normal transformation approach to comparing multiple clinical trial endpoints.

Publications

A marginal rank-based inverse normal transformation approach to comparing multiple clinical trial endpoints.

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