National Cancer Institute - NCI Division of Cancer Treatment and ...

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Evaluating Treatment Effects in the Presence of Competing Risks Competing risks are often encountered in clinical research. For example, a cancer patient may experience local failure or distant failure, or die without recurrence. In comparing treatments, use of endpoints based on the type of failure directly related to the treatment mechanism of action allows one to focus on the aspect of the disease targeted by treatment. Drs. Friedlin and Korn evaluate statistical methodology commonly used for testing failure-specific treatment effects. The article demonstrates that the cause- specific log-rank test is superior to the cumulative incidence-based approach. Freidlin B, Korn EL. Testing treatment effects in the presence of competing risks. Stat Med 2005:24;1703–12. Longitudinal Data Analysis Drs. Albert and Hunsberger have continued a productive research program to develop new methods for the analysis of longitudinal data. Most of this work has been motivated by problems in analyzing repeated biomarker measurements over time. A new methodology for analyzing longitudinal data based on a serial dilution assay was applied to data from a clinical trial examining the effect of acupuncture on reducing nausea associated with breast cancer treatment. Albert PS, Shen J. Modeling longitudinal semicontinuous emesis volume data with serial correlation in an acupuncture clinical trial. J R Stat Soc Ser C Appl Stat 2005:54;707–20. Albert PS. On the interpretation of marginal inference with a mixture model for clustered semi-continuous data. Biometrics 2005:61; 879–80. Albert PS. Hunsberger S. On analyzing circadian rhythm data using non-linear mixed models with harmonic terms. Biometrics 2005:61;1115–22. Albert PS, Follmann DA. Random effects and latent process approaches for longitudinal binary data with missingness: with applications to the analysis of opiate clinical trial data. To appear in Stat Methods Med Res. Evaluating Diagnostics in the Absence of a Gold Standard In 2004, Drs. Dodd and Albert published a paper on potential problems from estimating the diagnostic error of binary tests without a gold standard using latent class modeling. They showed that these approaches are sensitive to the dependence structure between tests, yet it is generally nearly impossible to distinguish between competing models. In a followup paper, they examine the robustness of the estimation procedures when, in a fraction of cases, we observe the gold standard test. They propose semi-latent modeling approaches for this problem and show that, even with a small percentage of gold standard information, estimates of diagnostic error are insensitive to the assumed dependence structure between tests. Albert PS, Dodd LA. Cautionary note on the robustness of latent class models for estimating diagnostic error without a gold standard. Biometrics 2004:60;427–35. Albert PS, Dodd L. On estimating diagnostic accuracy from studies with multiple raters and partial gold standard evaluation. In revision at J Am Stat Assoc. Albert PS. An imputation approach for estimating diagnostic accuracy from partially verified designs. Submitted to Biometrics. Albert PS. Misclassification models. In: Encyclopedia of Biostatistics. 2nd ed. Armitage P, Colton T, eds. New York: John Wiley & Sons; 2005. B I O M E T R I C R E S E A R C H B R A N C H ■ 23

O T H E R B I O S T A T I S T I C A L R E S E A R C H Smoothing-Based Approaches for Estimating the Risk of a Disease by Quantile-Categories of a Predictor Variable When one collects data on a prospective cohort, the standard method is simply to categorize the key predictor variable by the empirical quartiles. One may then include indicator variables for these empirical quartile-categories as predictors, along with other covariates, in a generalized linear model (GLM), with the observed health status of each subject as the response. The standard GLM method, however, is relatively inefficient because it treats all observations that fall in the same quartile-category of the predictor variable identically, regardless of whether they lie in the center or near the boundaries of that category. Alternatively, one may include the key predictor variable, along with other covariates, in a generalized additive model (GAM), again with the observed health status of each subject as the response. The alternative GAM method non-parametrically estimates the functional relationship between the key predictor variable and the response. One may then compute statistics of interest, such as proportions and odds ratios, from the fitted GAM equation using the empirical quartile-categories. Simulations show that both the GLM and GAM methods are nearly unbiased but that the latter method produces smaller variances and narrower bootstrap confidence intervals. This work by BRB’s Dr. Albert was motivated by collaborative work on NCI’s Polyp Prevention Trial. 24 ■ P R O G R A M A C C O M P L I S H M E N T S 2 0 0 6 Borkowf CB, Albert PS. Efficient estimation of risk of a disease by quantile-categories of a predictor variable using generalized additive models. Stat Med 2005:24;623–45. In case-control studies of genetic epidemiology, participating subjects (probands) are often interviewed to collect detailed data about disease history and age-atonset information in their family members. Genotype data are typically collected for the probands. In this article, Dr. Shih and collaborators consider an approach that utilizes family history data of the relatives. They used the methods for estimation of risk of breast cancer from BRCA1/2 mutations using data from the Washington Ashkenazi Study. Chatterjee N, Zeynep K, Shih JH, Gail M. Casecontrol and case-only designs with genotype and family history data: estimating relative-risk, familial aggregation and absolute risk. Biometrics [Epub Oct 20 2005]. Genomic Control for Association Studies under Various Genetic Models Case-control studies are commonly used to study whether a candidate allele and a disease are associated. However, spurious association can arise due to population substructure or cryptic relatedness, which cause the variance of the trend test to increase. A novel genomic control approach had been developed to estimate the “variance inflation factor” using an additive genetic model. Dr. Freidlin and collaborators expand this approach to recessive and dominant genetic models. They also discuss appropriate uses for their method and the one derived for the additive model.

O T H E R B I O S T A T I S T I C A L R E S E A R C H<br />

Smoothing-Based Approaches<br />

for Estimating the Risk <strong>of</strong> a<br />

Disease by Quantile-Categories<br />

<strong>of</strong> a Predictor Variable<br />

When one collects data on a prospective<br />

cohort, the st<strong>and</strong>ard method is simply<br />

to categorize the key predictor variable<br />

by the empirical quartiles. One may then<br />

include indicator variables for these<br />

empirical quartile-categories as predictors,<br />

along with other covariates, in a<br />

generalized linear model (GLM), with the<br />

observed health status <strong>of</strong> each subject as<br />

the response. The st<strong>and</strong>ard GLM method,<br />

however, is relatively inefficient because it<br />

treats all observations that fall in the same<br />

quartile-category <strong>of</strong> the predictor variable<br />

identically, regardless <strong>of</strong> whether they lie<br />

in the center or near the boundaries <strong>of</strong><br />

that category.<br />

Alternatively, one may include the key<br />

predictor variable, along with other<br />

covariates, in a generalized additive<br />

model (GAM), again with the observed<br />

health status <strong>of</strong> each subject as the<br />

response. The alternative GAM method<br />

non-parametrically estimates the functional<br />

relationship between the key<br />

predictor variable <strong>and</strong> the response. One<br />

may then compute statistics <strong>of</strong> interest,<br />

such as proportions <strong>and</strong> odds ratios, from<br />

the fitted GAM equation using the empirical<br />

quartile-categories. Simulations show<br />

that both the GLM <strong>and</strong> GAM methods<br />

are nearly unbiased but that the latter<br />

method produces smaller variances <strong>and</strong><br />

narrower bootstrap confidence intervals.<br />

This work by BRB’s Dr. Albert was motivated<br />

by collaborative work on <strong>NCI</strong>’s<br />

Polyp Prevention Trial.<br />

24 ■ P R O G R A M A C C O M P L I S H M E N T S 2 0 0 6<br />

Borkowf CB, Albert PS. Efficient estimation <strong>of</strong><br />

risk <strong>of</strong> a disease by quantile-categories <strong>of</strong> a<br />

predictor variable using generalized additive<br />

models. Stat Med 2005:24;623–45.<br />

In case-control studies <strong>of</strong> genetic epidemiology,<br />

participating subjects (prob<strong>and</strong>s)<br />

are <strong>of</strong>ten interviewed to collect detailed<br />

data about disease history <strong>and</strong> age-atonset<br />

information in their family members.<br />

Genotype data are typically collected for<br />

the prob<strong>and</strong>s. In this article, Dr. Shih <strong>and</strong><br />

collaborators consider an approach that<br />

utilizes family history data <strong>of</strong> the relatives.<br />

They used the methods for estimation<br />

<strong>of</strong> risk <strong>of</strong> breast cancer from BRCA1/2<br />

mutations using data from the Washington<br />

Ashkenazi Study.<br />

Chatterjee N, Zeynep K, Shih JH, Gail M. Casecontrol<br />

<strong>and</strong> case-only designs with genotype<br />

<strong>and</strong> family history data: estimating relative-risk,<br />

familial aggregation <strong>and</strong> absolute risk. Biometrics<br />

[Epub Oct 20 2005].<br />

Genomic Control for Association<br />

Studies under Various Genetic<br />

Models<br />

Case-control studies are commonly used<br />

to study whether a c<strong>and</strong>idate allele <strong>and</strong><br />

a disease are associated. However, spurious<br />

association can arise due to population<br />

substructure or cryptic relatedness,<br />

which cause the variance <strong>of</strong> the trend<br />

test to increase. A novel genomic control<br />

approach had been developed to estimate<br />

the “variance inflation factor” using an<br />

additive genetic model. Dr. Freidlin <strong>and</strong><br />

collaborators exp<strong>and</strong> this approach to<br />

recessive <strong>and</strong> dominant genetic models.<br />

They also discuss appropriate uses for<br />

their method <strong>and</strong> the one derived for<br />

the additive model.

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