Binary outcome is a commonly used endpoint in clinical trials. This
page illustrates how to conduct the unstratified or stratified analysis
with the Miettinen and Nurminen (M&N) method (Miettinen and Nurminen 1985) for risk
difference analysis in R. The following statistics can be calculated
with the function rate_compare()
:
Assume the data includes two independent binomial samples with binary response variables to be analyzed/summarized and the data collected in a clinical design without stratification. Also this approach is applicable to the case when the data are collected using a stratified clinical design and the statistician would like to ignore stratification by pooling the data over strata assuming two independent binomial samples. Assume Pi is the proportion of success responses in the test (i = 1) or control (i = 0) group.
The confidence interval is based on the M&N method and given by the roots for PD = P1 − P0 of the equation:
$$\chi_\alpha^2 = \frac{(\hat{p}_1-\hat{p}_0-PD)^2}{\tilde{V}}$$,
where p̂1 and p̂0 are the observed values of P1 and P0, respectively;
χα2 = the upper cut point of size α from the central chi-square distribution with 1 degree of freedom (χα2 = 3.84 for 95% confidence interval);
PD = the difference between two population proportions (PD = P1 − P0);
$$\tilde{V}=\bigg[\frac{\tilde{p}_1(1-\tilde{p}_1)}{n_1}+ \frac{\tilde{p}_0(1-\tilde{p}_0)}{n_0}\bigg]\frac{n_1+n_0}{n_1+n_0-1}$$;
n1 and n0 are the sample sizes for the test and control group, respectively;
p̃1 = maximum likelihood estimate of proportion on test computed as p̃0 + PD;
p̃0 = maximum likelihood estimate of proportion on control under the constraint p̃1 − p̃0 = PD.
As stated above the 2-sided 100(1 − α)% CI is given by the roots for PD = P1 − P0. The bisection algorithm is used in the function to obtain the two roots (confidence interval) for PD.
The Z-statistic is computed as:
$$Z_\text{diff}=\frac{\hat{p}_1-\hat{p}_0+S_0}{\sqrt{\tilde{V}}}$$ where p̂1 and p̂0 are the observed values for P1 and P0 respectively, S0 is pre-specified proportion difference under the null;
p̃1 = maximum likelihood estimate of proportion on test computed as p̃0 + S0;
p̃0 = maximum likelihood estimate of proportion on control under the constraint p̃1 − p̃0 = S0.
For non-inferiority or one-sided equivalence hypothesis with S0 > 0, the p-value, Pr (Z ≥ Zdiff | H0), is computed based on Zdiff using the standard normal distribution.
For non-inferiority or one-sided equivalence hypothesis with S0 < 0, the p-value, Pr (Z ≤ Zdiff | H0), is computed based on Zdiff using the standard normal distribution.
For two-sided superiority test, the p-value Pr (χdiff2 ≤ χ12 | H0), is computed based on χdiff2 using the chi-square distribution with 1 degree of freedom, where χdiff2 = Zdiff2.
Assume the data includes two treatment groups, test and control, and collected based on a stratified design. Within each stratum there are two independent binomial samples with binary response variables to be analyzed/summarized. The parameter of interest is the difference between the population proportions of the test and the control groups. The analysis and summaries need to be performed while adjusting for the stratifying variables.
The confidence interval is based on the M&N method and given by the roots for PD = P1 − P0 of the equation:
$$\chi_\alpha^2 = \frac{(\hat{p}_1^*-\hat{p}_0^*-PD)^2}{\sum_{i=1}^I(W_i/\sum_{k=1}^{K}W_k)^2\tilde{V}_i}$$,
where $\hat{p}_s^* = \sum_{i=1}^I(W_i/\sum_{k=1}^KW_k)\hat{p}_{s i}$ for s = 0, 1;
$$\tilde{V}_i=\bigg[\frac{\tilde{p}_{1i}(1-\tilde{p}_{1i})}{n_{1i}}+\frac{\tilde{p}_{0i}(1-\tilde{p}_{0i})}{n_{0i}}\bigg]\frac{n_{1i}+n_{0i}}{n_{1i}+n_{0i}-1}$$;
Similarly as for unstratified analysis,the 2-sided 100(1 − α)% CI is given by the roots for PD = P1 − P0, and the bisection algorithm is used in the function to obtain the two roots (confidence interval) for PD.
The Z-statistic is computed as:
$$Z_\text{diff}=\frac{\hat{p}_1^*-\hat{p}^*_0+S_0}{\sqrt{\sum_{i=1}^I(W_i/\sum_{k=1}^{K}W_k)^2\tilde{V}_i}}$$ where S0 is pre-specified proportion difference under the null;
The p-value can be calculated as stated above.
We simulated a dataset with 2 treatment group for binary output. If stratum is used, we considered 4 stratum.
The function computes the risk difference, Z-statistic, p-value given the type of test, and two-sided 100(1 − α)% confidence interval of difference between two rates.
The sample size weighting is often used in the clinical trial. Below is the function to conduct stratified MN analysis with sample size weights.
We also support weight in "equal"
and
"cmh"
. More details can be found in the
rate_compare()
documentation.