• Title/Summary/Keyword: Non-inferiority

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Statistical Methods in Non-Inferiority Trials - A Focus on US FDA Guidelines -

  • Kang, Seung-Ho;Wang, So-Young
    • The Korean Journal of Applied Statistics
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    • v.25 no.4
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    • pp.575-587
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    • 2012
  • The effect of a new treatment is proven through the comparison of a new treatment with placebo; however, the number of parent non-inferiority trials tends to grow proportionally to the number of active controls. In a non-inferiority trial a new treatment is approved by proof that the new treatment is not inferior to an active control; however, both additional assumptions and historical trials are needed to show (through the comparison of the new treatment with the active control in a non-inferiority trial) that the new treatment is more efficacious than a putative placebo. The two different methods of using the historical data: frequentist principle method and meta-analytic method. This paper discusses the statistical methods and different Type I error rates obtained through the different methods employed.

Comparative Analysis of Two Independent Proportions in Non-Inferiority Trials (비열등성 임상시험에서 독립인 두 비율 차 검정에 대한 비교 연구)

  • Yoon, Min;Kwak, Min-Jung
    • The Korean Journal of Applied Statistics
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    • v.23 no.6
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    • pp.1115-1124
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    • 2010
  • Normal approximation methods under the null hypothesis of no difference are frequently used to test the two independent proportions in non-inferiority trials. However, these tests are not appropriate under the null hypothesis of non-zero difference. We review the likelihood score methods proposed by Miettinen and Nurminen, Farrington and Manning, and Gart and Nam and compare the performance of these tests. The simulation study shows that the likelihood score tests under the null hypothesis of non-zero difference have better performance at a Type I error and power than usual normal approximation methods.

Non-Inferiority Test in a Two-Arm Trial and a Three-Arm Trial Including a Placebo (활성대조군을 이용한 두 군 설계와 위약군을 포함한 세 군 설계의 비열등성 시험)

  • Lee, Ji-Sun;Kim, Dong-Jae
    • The Korean Journal of Applied Statistics
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    • v.21 no.6
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    • pp.947-957
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    • 2008
  • Two-arm non-inferiority trials is often applied to parametric procedure suggested by Hauschke et al. (1999). Since this design does not allow a direct comparison of a new treatment group with placebo group, parametric procedure in a three-arm non-inferiority trial with a placebo group was suggested by Pigeot et al. (2003). But, procedures in these designs are necessary for distribution assumptions. Therefore we propose, in this paper, non parametric procedures employing Wilcoxon rank sum test in a two-arm design and linear contrast test suggested by Scheirer et al. (1976) in a three-arm design. The proposed nonparametric procedures and parametric procedures are compared by Monte Carlo simulation study.

Sample Size Comparison for Non-Inferiority Trials

  • Kim, Dong-Wook;Kim, Dong-Jae
    • Journal of the Korean Data and Information Science Society
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    • v.18 no.2
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    • pp.411-418
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    • 2007
  • Sample size calculation is very important in clinical trials. In this paper, we propose sample size calculation method for non-inferiority trials using sample size calculation method suggested by Wang et al.(2003) based on Wilcoxon's rank sum test. Also, sample size comparison between parametric method and proposed method are presented.

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Nonparametric Method for a Non-inferiority Test using Confidence Interval (신뢰구간을 이용한 비열등성 시험에서 비모수적 검정법)

  • Park, Sujung;Kim, Dongjae
    • The Korean Journal of Applied Statistics
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    • v.27 no.5
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    • pp.833-842
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    • 2014
  • Non-inferiority trials indicate whether the effect of an experimental treatment is not worse than an active control. Chen et al. (2006) and Kang (2010) proposed a test method for non-inferiority trials using confidence intervals. In this paper, we suggest a new nonparametric method using a confidence interval based on Wilcoxon rank-sum test and Hodges-Lehmann estimator of active control. A Monte-Carlo simulation study compares the type I error and the power of the proposed method with previous methods.

A non-inferiority study evaluating a new extended-release preparation of tilmicosin injected subcutaneously vs. ceftiofur administered intramammary, as dry-cow therapy in Holstein Friesian cows

  • Ortega, Esteban;Alfonseca-Silva, Edgar;Posadas, Eduardo;Tapia, Graciela;Sumano, Hector
    • Journal of Veterinary Science
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    • v.21 no.6
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    • pp.87.1-87.11
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    • 2020
  • Background: A new, extended long-acting tilmicosin (TLAe) preparation was tested against intramammary ceftiofur (CEF) using a non-inferiority trial model during dry-cow therapy (DCT) in a farm with high bovine population density and deficient hygiene application. Objectives: To evaluate the possibility that TLAe administered parenterally can achieve non-inferiority status compared to CEF administered intramammary for DCT. Methods: Cows were randomly assigned to TLAe (20 mg/kg subcutaneous; n = 53) or CEF (CEF-HCl, 125 mg/quarter; n = 38 cows) treatment groups. California mastitis testing, colony-forming unit assessment (CFU/mL), and number of cases positive for Staphylococcus aureus were quantified before DCT and 7 d after calving. A complete cure was defined as no bacteria isolated; partial cure when CFU/mL ranged from 150 to 700, and cure-failure when CFU/mL was above 700. Results: TLAe and CEF had overall cure rates of 57% and 53% (p > 0.05) and S. aureus cure rates of 77.7% and 25%, respectively (p < 0.05). The pathogens detected at DCT and 7 days after calving were S. aureus (62.71% and 35.55%), Staphylococcus spp. (22.03% and 35.55%), Streptococcus uberis (10.16% and 13.33%), and Escherichia coli (5.08% and 15.55%). Non-inferiority and binary logistic regression analyses revealed a lack of difference in overall efficacies of TLAe and CEF. Apart from S. aureus, S. uberis was the predominant pathogen found in both groups. Conclusions: This study is the first successful report of parenteral DCT showing comparable efficacy as CEF, the gold-standard. The extended long-term pharmacokinetic activity of TLAe explains these results.

Sample size determination based on placements for non-inferiority trials (비열등성 시험에서 위치 방법에 기초한 표본 수 결정)

  • Kim, Jiyeon;Kim, Dongjae
    • Journal of the Korean Data and Information Science Society
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    • v.24 no.6
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    • pp.1349-1357
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    • 2013
  • In clinical research, sample size determination is one of the most important things. There are parametric method using t-test and non-parametric method suggested by Kim and Kim (2007) based on Wilcoxon's rank sum test for determining sample size in non-inferiority trials. In this paper, we propose sample size calculation method based on placements method suggested by Orban and Wolfe (1982) and using the power calculated by Kim (1994) in non-inferiority trials. We also compare proposed sample size with that using Kim and Kim (2007)'s formula and that of t-test for parametric methods. As the result, sample size calculated by proposed method based on placements is the smallest. Therefore, proposed method based on placements is better than parametric methods in case that it's hard to assume specific distribution function for population and also more efficient in terms of time and cost than method based on Wilcoxon's rank sum test.

The Exoscope versus operating microscope in microvascular surgery: A simulation non-inferiority trial

  • Pafitanis, Georgios;Hadjiandreou, Michalis;Alamri, Alexander;Uff, Christopher;Walsh, Daniel;Myers, Simon
    • Archives of Plastic Surgery
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    • v.47 no.3
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    • pp.242-249
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    • 2020
  • Background The Exoscope is a novel high-definition digital camera system. There is limited evidence signifying the use of exoscopic devices in microsurgery. This trial objectively assesses the effects of the use of the Exoscope as an alternative to the standard operating microscope (OM) on the performance of experts in a simulated microvascular anastomosis. Methods Modus V Exoscope and OM were used by expert microsurgeons to perform standardized tasks. Hand-motion analyzer measured the total pathlength (TP), total movements (TM), total time (TT), and quality of end-product anastomosis. A clinical margin of TT was performed to prove non-inferiority. An expert performed consecutive microvascular anastomoses to provide the exoscopic learning curve until reached plateau in TT. Results Ten micro sutures and 10 anastomoses were performed. Analysis demonstrated statistically significant differences in performing micro sutures for TP, TM, and TT. There was statistical significance in TM and TT, however, marginal non-significant difference in TP regarding microvascular anastomoses performance. The intimal suture line analysis demonstrated no statistically significant differences. Non-inferiority results based on clinical inferiority margin (Δ) of TT=10 minutes demonstrated an absolute difference of 0.07 minutes between OM and Exoscope cohorts. A 51%, 58%, and 46% improvement or reduction was achieved in TT, TM, TP, respectively, during the exoscopic microvascular anastomosis learning curve. Conclusions This study demonstrated that experts' Exoscope anastomoses appear non-inferior to the OM anastomoses. Exoscopic microvascular anastomosis was more time consuming but end-product (patency) in not clinically inferior. Experts' "warm-up" learning curve is steep but swift and may prove to reach clinical equality.

Clearance Depth Control for the Non-explosive Demining System of a Tracked Mobile Robot (비폭파식 지뢰제거 무한궤도형 주행 로봇의 작업 깊이 제어)

  • Jeong Hae Kwan;Choi Hyun Do;Kim Sang Do;Kwak Yoon Keun
    • Journal of the Korean Society for Precision Engineering
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    • v.22 no.9 s.174
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    • pp.155-161
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    • 2005
  • Up to now, a lot of unmanned demining systems have been developed. However, some inferiority surely exist by reason of their large platform and explosive mechanism. To settle this inferiority, non-explosive demining system adaptable to a mobile robot already has been developed. Brief experiment indoors showed that developed demining system can remove landmines well. But, out of doors, several problems are detected. In this research, a study on the performance improvement of developed non-explosive demining system is mainly discussed. To overcome downhill effect, mechanical sensor composed of shaft and spring is used. It is confirmed that clearance depth control using the mechanical sensor is a good solution for the inclination of the system.

An Approximate Unconditional Test of Non-Inferiority for Two Proportions Based on Odds Ratio (두 모비율의 비열등성 시험에서 오즈비를 이용한 근사 무조건적 검정)

  • Seo, Young-Yeol;Kim, Dong-Jae
    • The Korean Journal of Applied Statistics
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    • v.22 no.4
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    • pp.793-804
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    • 2009
  • The hypotheses of difference, ratio and odds ratio between two proportions are used for the non-inferiority trial. The approximate unconditional test suggested by Kang and Chen (2000) based on difference and ratio have the potential problem against the failure rate. When the sample size is small, the type I errors of the asymptotic test using the normal approximation suggested by Chen et al. (2000) tends to exceed the nominal level. Therefore, we propose the approximate unconditional test based on odds ratio and compare the test with the asymptotic test. And we compare the three hypotheses used in the approximate unconditional tests of two proportions with respect to the type I errors and power.