A note on non‐parametric ANCOVA for covariate adjustment in randomized clinical trials

Koch et al. recently (1998) proposed two covariate‐adjusted approaches for the comparison of continuous, ordinal and binary responses in a randomized clinical trial (Statist. Med. 1998; 17: 1863–1892). The first is a randomization approach while the second assumes that the study is a sample of a population. Here, we study the second approach and consider the simplest cases of two treatments with a continuous response and with a binary response. Koch's second approach will be compared with the classical ANCOVA for a continuous response. From this relationship we demonstrate that Koch's method cannot preserve the probability of the type I error. Simulations with continuous responses as well as with binary outcomes confirm the aforementioned theoretical result on the performance of Koch's method under the null hypothesis of no treatment effect. However, this poses only a problem for relatively small to moderate sample sizes. Further, as specified in the original paper of Koch et al., the first approach does preserve the type I error for any sample size, as the P‐values can be reported in an exact manner (Statist. Med. 1998; 17: 1863–1892). Finally, we propose a correction factor for Koch's test statistic that better preserves the type I error. Copyright © 2003 John Wiley & Sons, Ltd.

[1]  E. Lesaffre,et al.  On the variability of covariate adjustment. experience with Koch's method for evaluating the absolute difference in proportions in randomized clinical trials. , 2002, Controlled clinical trials.

[2]  F. Van de Werf,et al.  The general concepts of an equivalence trial, applied to ASSENT-2, a large-scale mortality study comparing two fibrinolytic agents in acute myocardial infarction. , 2001, European heart journal.

[3]  G M Raab,et al.  How to select covariates to include in the analysis of a clinical trial. , 2000, Controlled clinical trials.

[4]  Stephen Senn Consensus and Controversy in Pharmaceutical Statistics , 2000 .

[5]  Gary G. Koch,et al.  Nonparametric Analysis of Covariance and Its Role in Noninferiority Clinical Trials , 1999 .

[6]  F. Werf Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial , 1999, The Lancet.

[7]  D Edwards,et al.  On model prespecification in confirmatory randomized studies. , 1999, Statistics in medicine.

[8]  G G Koch,et al.  Issues for covariance analysis of dichotomous and ordered categorical data from randomized clinical trials and non-parametric strategies for addressing them. , 1998, Statistics in medicine.

[9]  F. Harrell,et al.  Cardiac Troponin T Levels for Risk Stratification in Acute Myocardial Ischemia , 1996 .

[10]  Carl-Fredrik Burman,et al.  On Sequential Treatment Allocations in Clinical Trials , 1996 .

[11]  J Col,et al.  Predictors of 30-day mortality in the era of reperfusion for acute myocardial infarction. Results from an international trial of 41,021 patients. GUSTO-I Investigators. , 1995, Circulation.

[12]  S. Senn Testing for baseline balance in clinical trials. , 1994, Statistics in medicine.

[13]  Frans Van de Werf,et al.  An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. , 1993, The New England journal of medicine.

[14]  N. Jewell,et al.  Some surprising results about covariate adjustment in logistic regression models , 1991 .

[15]  D. Stoyan Stereology and stochastic geometry , 1990 .

[16]  P. Meier,et al.  Choosing covariates in the analysis of clinical trials. , 1989, Controlled clinical trials.

[17]  S J Senn,et al.  Covariate imbalance and random allocation in clinical trials. , 1989, Statistics in medicine.

[18]  P. McCullagh,et al.  Some aspects of analysis of covariance. , 1982, Biometrics.

[19]  A. Atkinson Optimum biased coin designs for sequential clinical trials with prognostic factors , 1982 .

[20]  S. Pocock,et al.  Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial. , 1975, Biometrics.

[21]  D R Taves,et al.  Minimization: A new method of assigning patients to treatment and control groups , 1974, Clinical pharmacology and therapeutics.