Linearly divergent treatment effects in clinical trials with repeated measures: efficient analysis using summary statistics.

In many randomized clinical trials with repeated measures of a response variable one anticipates a linear divergence over time in the difference between treatments. This paper explores how to make an efficient choice of analysis based on individual patient summary statistics. With the objective of estimating the mean rate of treatment divergence the simplest choice of summary statistic is the regression coefficient of response on time for each subject (SLOPE). The gains in statistical efficiency imposed by adjusting for the observed pre-treatment levels, or even better the estimated intercepts, are clarified. In the process, we develop the optimal linear summary statistic for any repeated measures design with assumed known covariance structure and shape of true mean treatment difference over time. Statistical power considerations are explored and an example from an asthma trial is used to illustrate the main points.

[1]  T. Bradstreet Using orthogonal polynomial scores in summarizing and evaluating longitudinal data collected in phase I and II clinical pharmacology studies. , 1993, Statistics in medicine.

[2]  S. Senn,et al.  Repeated measures in clinical trials: analysis using mean summary statistics and its implications for design. , 1994, Statistics in medicine.

[3]  C. R. Rao,et al.  Linear Statistical Inference and its Applications , 1968 .

[4]  M. Hughes,et al.  Effects of 22 months of treatment with inhaled corticosteroids and/or beta-2-agonists on lung function, airway responsiveness, and symptoms in children with asthma. The Dutch Chronic Non-specific Lung Disease Study Group. , 1992, The American review of respiratory disease.

[5]  A. J. Collins,et al.  Introduction To Multivariate Analysis , 1981 .

[6]  P. O'Brien Procedures for comparing samples with multiple endpoints. , 1984, Biometrics.

[7]  S W Lagakos,et al.  Size and power of two-sample tests of repeated measures data. , 1993, Biometrics.

[8]  John Wishart,et al.  GROWTH-RATE DETERMINATIONS IN NUTRITION STUDIES WITH THE BACON PIG, AND THEIR ANALYSIS , 1938 .

[9]  Richard A. Johnson,et al.  Applied Multivariate Statistical Analysis , 1983 .

[10]  N M Laird,et al.  Estimating rates of change in randomized clinical trials. , 1990, Controlled clinical trials.

[11]  N L Geller,et al.  The analysis of multiple endpoints in clinical trials. , 1987, Biometrics.

[12]  S W Lagakos,et al.  Analyzing laboratory marker changes in AIDS clinical trials. , 1991, Journal of acquired immune deficiency syndromes.

[13]  R. Potthoff,et al.  A generalized multivariate analysis of variance model useful especially for growth curve problems , 1964 .

[14]  M. J. R. Healy,et al.  The analysis of experiments on growth rate. , 1959 .

[15]  S Senn,et al.  Analysis of serial measurements in medical research. , 1990, BMJ.

[16]  D. M. Allen,et al.  Analysis of growth and dose response curves. , 1969, Biometrics.

[17]  J. G. Rowell,et al.  Analysing data with repeated observations on each experimental unit , 1976, The Journal of Agricultural Science.

[18]  S. Thompson,et al.  Multi-level models for repeated measurement data: application to quality of life data in clinical trials. , 1996, Statistics in medicine.