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含时间趋势试验中的估计目标与估计方法AI 解读

In platform trials, model-based approaches typically estimate treatment effects conditional on calendar time. However, scientific and regulatory interest often lies in treatment effects defined for a target population spanning multiple enrollment periods, requiring explicit consideration of how effects should be averaged across time. This raises two fundamental challenges. The first is the definition of the appropriate target estimand when combining data across multiple…

小样本多协变量随机对照试验中的G计算AI 解读

In contemporary randomized controlled trials (RCTs), the number of patients is often small relative to the number of baseline covariates collected. In such settings, maximum likelihood estimators of conditional treatment effects in generalized linear models, along with their standard errors, may exhibit substantial bias. This study examines whether similar bias arises in G-computation estimators of marginal treatment effects, which are known for their robustness to model…

多中心随机试验中的稳健协变量调整AI 解读

Augmented inverse probability weighting and G-computation with canonical generalized linear models have become increasingly popular for estimating the average treatment effect (ATE) in randomized experiments. These methods leverage outcome prediction models to adjust for imbalances in baseline covariates across treatment arms, improving power compared to unadjusted analyses, while controlling Type I error, even when models are misspecified. In multi-center trials they are…

监管试验协变量调整的良好实践：从固定到数据自适应方法AI 解读

While randomization justifies the use of unadjusted effect estimators in randomized trials, there is growing interest in covariate adjustment to improve precision. Adjusting for baseline variables that are prognostic of the outcome can reduce estimator variance, resulting in narrower confidence intervals and increased statistical power. Recent guidance by the U.S. Food and Drug Administration supports fixed adjustment for prognostic covariates using parametric regression…

通过数据驱动协变量调整实现随机临床试验的自动化高效无模型推断AI 解读

In 2023, the U.S. Food and Drug Administration issued guidance for adjustment of covariates in randomized clinical trials, emphasizing its role in enhancing precision and power through prognostic baseline variables. Despite its potential, many trials underutilize this method partly due to challenges in pre-specifying optimal baseline covariates and their functional forms. We explore the potential of automated, data-adaptive methods-including stepwise regression, Lasso and…

死亡截断及其他中间事件下纵向研究治疗效应的稳健评估AI 解读

Intercurrent events, such as treatment switching, rescue medication, dropout, or truncation by death, frequently complicate intention-to-treat analyses in randomized clinical trials. Existing causal inference frameworks typically target hypothetical or principal stratum estimands (e.g., survivor average causal effects), which rely on unverifiable assumptions and can be sensitive to unmeasured confounders or positivity violations. We propose a novel approach that mitigates…

随机对照试验中协变量调整的使用：综述AI 解读

There has been a growing interest in covariate adjustment in the analysis of randomized controlled trials in past years. For instance, the U.S. Food and Drug Administration recently issued guidance that emphasizes the importance of distinguishing between conditional and marginal treatment effects. Although these effects coincide in linear models, this is not typically the case in other settings, and this distinction is often overlooked in clinical trial practice. Considering…

受新冠疫情影响的临床试验：目标估计量及其估计方法AI 解读

The COVID-19 pandemic continues to affect the conduct of clinical trials globally. Complications may arise from pandemic-related operational challenges such as site closures, travel limitations and interruptions to the supply chain for the investigational product, or from health-related challenges such as COVID-19 infections. Some of these complications lead to unforeseen intercurrent events in the sense that they affect either the interpretation or the existence of the…

变量选择后危险比推断的有效性AI 解读

The problem of how to best select variables for confounding adjustment forms one of the key challenges in the evaluation of exposure effects in observational studies, and has been the subject of vigorous recent activity in causal inference. A major drawback of routine procedures is that there is no finite sample size at which they are guaranteed to deliver exposure effect estimators and associated confidence intervals with adequate performance. In this work, we will consider…