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How to use likelihood ratios to interpret evidence from randomized trials
1Division of Clinical Epidemiology, Geneva University Hospitals, and Faculty of Medicine, University of Geneva, Geneva 1211, Switzerland.
Objective:
The likelihood ratio is a method for assessing evidence regarding two simple statistical hypotheses. Its interpretation is simple - for example, a value of 10 means that the first hypothesis is 10 times as strongly supported by the data as the second. A method is shown for deriving likelihood ratios from published trial reports.
Study Design:
The likelihood ratio compares two hypotheses in light of data: that a new treatment is effective, at a specified level (alternate hypothesis: for instance, the hazard ratio equals 0.7), and that it is not (null hypothesis: the hazard ratio equals 1). The result of the trial is summarised by the test statistic z (ie, the estimated treatment effect divided by its standard error). The expected value of z is 0 under the null hypothesis, and A under the alternate hypothesis. The logarithm of the likelihood ratio is given by z·A - A2/2. The values of A and z can be derived from the alternate hypothesis used for sample size computation, and from the observed treatment effect and its standard error or confidence interval.
Results:
Examples are given of trials that yielded strong or moderate evidence in favor of the alternate hypothesis, and of a trial that favored the null hypothesis. The resulting likelihood ratios are applied to initial beliefs about the hypotheses to obtain posterior beliefs.
Conclusions:
The likelihood ratio is a simple and easily understandable method for assessing evidence in data about two competing a priori hypotheses.
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