加强对区域差异的洞察力:多区域临床试验中的层次线性模型
Jeewuan Kim1,2, Seung-Ho Kang3,4
1Department of Statistics and Data Science, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
BMC medical research methodology
|March 13, 2025
概括
层次线性模型 (HLM) 有效地解决了多区域临床试验 (MRCT) 中的区域差异. 这些模型通过考虑未知的因素和预算限制,提高了试验设计效率.
科学领域:
- 临床试验方法论 临床试验方法论
- 统计建模 统计建模
- 药学研究 药学研究
背景情况:
- 多区域临床试验 (MRCT) 越来越多地用于全球药物开发.
- 国际协调理事会E17指南强调需要解决MRCT的区域差异.
- 由于患者内在和外在因素造成的区域差异,对MRCT的设计和分析构成挑战.
研究的目的:
- 引入和研究用于分析MRCT的层次线性模型 (HLM).
- 通过在拦截和斜率中结合随机效应来增强HLM,以获得更大的灵活性.
- 根据预算限制,开发HLM样本大小计算的方法.
主要方法:
- 使用等级线性模型 (HLM),用于已知因素的共变量和未知因素的随机效应.
- 扩展了HLM,包括截面和斜率的随机效应.
- 开发了考虑固定的地区和预算限制的样本大小确定方法.
主要成果:
- 随机拦截和斜率效应的HLM在区域数量充足时产生准确的I型错误率和功率.
- 对于少数地区来说,估计区域差异是具有挑战性的.
- 预算限制影响地区数量,每个地区的患者数量取决于治疗效果的变化.
结论:
- 提出了一个强大的框架,用于管理MRCT的区域终点差异.
- 建议的策略,包括数字和预算意识的样本大小计算,提高MRCT设计效率.
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