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Mediana is an R package which provides a general framework for clinical trial simulations based on the Clinical Scenario Evaluation approach. The package supports a broad class of data models (including clinical trials with continuous, binary, survival-type and count-type endpoints as well as multivariate outcomes that are based on combinations of different endpoints), analysis strategies and commonly used evaluation criteria.
Package design: Alex Dmitrienko (Mediana Inc.).
Core development team: Gautier Paux (Servier), Alex Dmitrienko (Mediana Inc.).
Extended development team: Thomas Brechenmacher (Novartis), Fei Chen (Johnson and Johnson), Ilya Lipkovich (Quintiles), Ming-Dauh Wang (Lilly), Jay Zhang (MedImmune), Haiyan Zheng (Osaka University).
Expert team: Keaven Anderson (Merck), Frank Harrell (Vanderbilt University), Mani Lakshminarayanan (Pfizer), Brian Millen (Lilly), Jose Pinheiro (Johnson and Johnson), Thomas Schmelter (Bayer).
Install the latest version of the Mediana package from CRAN using the install.packages
command in R:
Alternatively, you can download the package from the CRAN website.
The up-to-date development version can be found and installed directly from the GitHub web site. You need to install the devtools
package and then call the install_github
function in R:
The Mediana R package was developed to provide a general software implementation of the Clinical Scenario Evaluation (CSE) framework. This framework introduced by Benda et al. (2010) and Friede et al. (2010) recognizes that sample size calculation and power evaluation in clinical trials are high-dimensional statistical problems. This approach helps decompose this complex problem by identifying key elements of the evaluation process. These components are termed models:
Find out more about the role of each model and how to specify the three models to perform Clinical Scenario Evaluation by reviewing the dedicated pages (click on the links above).
Multiple case studies are provided on the web site’s package to facilitate the implementation of Clinical Scenario Evaluation in different clinical trial settings using the Mediana package. These case studies will be updated on a regular basis. Another vignette accessible with the following command is also available presenting these case studies.
The Mediana package has been successfully used in multiple clinical trials to perform power calculations as well as optimally select trial designs and analysis strategies (clinical trial optimization). For more information on applications of the Mediana package, download the following papers:
Data models define the process of generating patient data in clinical trials.
A data model can be initialized using the following command
It is highly recommended to use this command as it will simplify the process of specifying components of the data model, e.g., OutcomeDist
, Sample
, SampleSize
, Event
and Design
objects.
Once the DataModel
object has been initialized, components of the data model can be specified by adding objects to the model using the ‘+’ operator as shown below.
# Outcome parameter set 1
outcome1.placebo = parameters(mean = 0, sd = 70)
outcome1.treatment = parameters(mean = 40, sd = 70)
# Outcome parameter set 2
outcome2.placebo = parameters(mean = 0, sd = 70)
outcome2.treatment = parameters(mean = 50, sd = 70)
# Data model
case.study1.data.model = DataModel() +
OutcomeDist(outcome.dist = "NormalDist") +
SampleSize(c(50, 55, 60, 65, 70)) +
Sample(id = "Placebo",
outcome.par = parameters(outcome1.placebo, outcome2.placebo)) +
Sample(id = "Treatment",
outcome.par = parameters(outcome1.treatment, outcome2.treatment))
OutcomeDist
objectThis object specifies the distribution of patient outcomes in a data model. An OutcomeDist
object is defined by two arguments:
outcome.dist
defines the outcome distribution.
outcome.type
defines the outcome type (optional). There are two acceptable values of this argument: standard
(fixed-design setting) and event
(event-driven design setting).
Several distributions that can be specified using the outcome.dist
argument are already implemented in the Mediana package. These distributions are listed below along with the required parameters to be included in the outcome.par
argument of the Sample
object:
UniformDist
: generate data following a univariate distribution. Required parameter: max
.
NormalDist
: generate data following a normal distribution. Required parameters: mean
and sd
.
BinomDist
: generate data following a binomial distribution. Required parameter: prop
.
BetaDist
: generate data following a beta distribution. Required parameter: a
and b
.
ExpoDist
: generate data following an exponential distribution. Required parameter: rate
.
WeibullDist
: generate data following a weibull distribution. Required parameter: shape
and scale
.
TruncatedExpoDist
: generate data following a truncated exponential distribution. Required parameter: rate
an trunc
.
PoissonDist
: generate data following a Poisson distribution. Required parameter: lambda
.
NegBinomDist
: generate data following a negative binomial distribution. Required parameters: dispersion
and mean
.
MultinomialDist
: generate data following a multinomial distribution. Required parameters: prob
.
MVNormalDist
: generate data following a multivariate normal distribution. Required parameters: par
and corr
. For each generated endpoint, the par
parameter must contain the required parameters mean
and sd
. The corr
parameter specifies the correlation matrix for the endpoints.
MVBinomDist
: generate data following a multivariate binomial distribution. Required parameters: par
and corr
. For each generated endpoint, the par
parameter must contain the required parameter prop
. The corr
parameter specifies the correlation matrix for the endpoints.
MVExpoDist
: generate data following a multivariate exponential distribution. Required parameters: par
and corr
. For each generated endpoint, the par
parameter must contain the required parameter rate
. The corr
parameter specifies the correlation matrix for the endpoints.
MVExpoPFSOSDist
: generate data following a multivariate exponential distribution to generate PFS and OS endpoints. The PFS value is imputed to the OS value if the latter occurs earlier. Required parameters: par
and corr
. For each generated endpoint, the par
parameter must contain the required parameter rate
. Thecorr
parameter specifies the correlation matrix for the endpoints.
MVMixedDist
: generate data following a multivariate mixed distribution. Required parameters: type
, par
and corr
. The type
parameter assumes the following values: NormalDist
, BinomDist
and ExpoDist
. For each generated endpoint, the par
parameter must contain the required parameters according to the distribution type. The corr
parameter specifies the correlation matrix for the endpoints.
The outcome.type
argument defines the outcome’s type. This argument accepts only two values:
standard
: for fixed design setting.
event
: for event-driven design setting.
The outcome’s type must be defined for each endpoint in case of multivariate disribution, e.g. c("event","event")
in case of multivariate exponential distribution. The outcome.type
argument is essential to get censored events for time-to-event endpoints if the SampleSize
object is used to specify the number of patients to generate.
A single OutcomeDist
object can be added to a DataModel
object.
For more information about the OutcomeDist
object, see the documentation for OutcomeDist on the CRAN web site.
If a certain outcome distribution is not implemented in the Mediana package, the user can create a custom function and use it within the package (see the dedicated vignette vignette("custom-functions", package = "Mediana")
).
Examples of OutcomeDist
objects:
Specify popular univariate distributions:
# Normal distribution
OutcomeDist(outcome.dist = "NormalDist")
# Binomial distribution
OutcomeDist(outcome.dist = "BinomDist")
# Exponential distribution
OutcomeDist(outcome.dist = "ExpoDist")
Specify a mixed multivariate distribution:
Sample
objectThis object specifies parameters of a sample (e.g., treatment arm in a trial) in a data model. Samples are defined as mutually exclusive groups of patients, for example, treatment arms. A Sample
object is defined by three arguments:
id
defines the sample’s unique ID (label).
outcome.par
defines the parameters of the outcome distribution for the sample.
sample.size
defines the sample’s size (optional).
The sample.size
argument is optional but must be used to define the sample size only if an unbalanced design is considered (i.e., the sample size varies across the samples). The sample size must be either defined in the Sample
object or in the SampleSize
object, but not in both.
Several Sample
objects can be added to a DataModel
object.
For more information about the Sample
object, see the documentation Sample on the CRAN web site.
Examples of Sample
objects:
Specify two samples with a continuous endpoint following a normal distribution:
# Outcome parameters set 1
outcome1.placebo = parameters(mean = 0, sd = 70)
outcome1.treatment = parameters(mean = 40, sd = 70)
# Outcome parameters set 2
outcome2.placebo = parameters(mean = 0, sd = 70)
outcome2.treatment = parameters(mean = 50, sd = 70)
# Placebo sample object
Sample(id = "Placebo",
outcome.par = parameters(outcome1.placebo,
outcome2.placebo))
# Treatment sample object
Sample(id = "Treatment",
outcome.par = parameters(outcome1.treatment,
outcome2.treatment))
Specify two samples with a binary endpoint following a binomial distribution:
# Outcome parameters set
outcome.placebo = parameters(prop = 0.30)
outcome.treatment = parameters(prop = 0.50)
# Placebo sample object
Sample(id = "Placebo",
outcome.par = parameters(outcome1.placebo))
# Treatment sample object
Sample(id = "Treatment",
outcome.par = parameters(outcome1.treatment))
Specify two samples with a time-to-event (survival) endpoint following an exponential distribution:
# Outcome parameters
median.time.placebo = 6
rate.placebo = log(2)/median.time.placebo
outcome.placebo = parameters(rate = rate.placebo)
median.time.treatment = 9
rate.treatment = log(2)/median.time.treatment
outcome.treatment = parameters(rate = rate.treatment)
# Placebo sample object
Sample(id = "Placebo",
outcome.par = parameters(outcome.placebo))
# Treatment sample object
Sample(id = "Treatment",
outcome.par = parameters(outcome.treatment))
Specify three samples with two primary endpoints that follow a binomial and a normal distribution, respectively:
# Variable types
var.type = list("BinomDist", "NormalDist")
# Outcome distribution parameters
placebo.par = parameters(parameters(prop = 0.3),
parameters(mean = -0.10, sd = 0.5))
dosel.par = parameters(parameters(prop = 0.40),
parameters(mean = -0.20, sd = 0.5))
doseh.par = parameters(parameters(prop = 0.50),
parameters(mean = -0.30, sd = 0.5))
# Correlation between two endpoints
corr.matrix = matrix(c(1.0, 0.5,
0.5, 1.0), 2, 2)
# Outcome parameters set
outcome.placebo = parameters(type = var.type,
par = plac.par,
corr = corr.matrix)
outcome.dosel = parameters(type = var.type,
par = dosel.par,
corr = corr.matrix)
outcome.doseh = parameters(type = var.type,
par = doseh.par,
corr = corr.matrix)
# Placebo sample object
Sample(id = list("Plac ACR20", "Plac HAQ-DI"),
outcome.par = parameters(outcome.placebo))
# Low Dose sample object
Sample(id = list("DoseL ACR20", "DoseL HAQ-DI"),
outcome.par = parameters(outcome.dosel))
# High Dose sample object
Sample(id = list("DoseH ACR20", "DoseH HAQ-DI"),
outcome.par = parameters(outcome.doseh))
SampleSize
objectThis object specifies the sample size in a balanced trial design (all samples will have the same sample size). A SampleSize
object is defined by one argument:
sample.size
specifies a list or vector of sample size(s).A single SampleSize
object can be added to a DataModel
object.
For more information about the SampleSize
object, see the package’s documentation SampleSize.
Examples of SampleSize
objects:
Several equivalent specifications of the SampleSize
object:
Event
objectThis object specifies the total number of events (total event count) among all samples in an event-driven clinical trial. An Event
object is defined by two arguments:
n.events
defines a vector of the required event counts.
rando.ratio
defines a vector of randomization ratios for each Sample
object defined in the DataModel
object.
A single Event
object can be added to a DataModel
object.
For more information about the Event
object, see the package’s documentation Event.
Examples of Event
objects:
Specify the required number of events in a trial with a 2:1 randomization ratio (Treatment:Placebo):
Design
objectThis object specifies the design parameters used in event-driven designs if the user is interested in modeling the enrollment (or accrual) and dropout (or loss to follow up) processes. A Design
object is defined by seven arguments:
enroll.period
defines the length of the enrollment period.
enroll.dist
defines the enrollment distribution.
enroll.dist.par
defines the parameters of the enrollment distribution (optional).
followup.period
defines the length of the follow-up period for each patient in study designs with a fixed follow-up period, i.e., the length of time from the enrollment to planned discontinuation is constant across patients. The user must specify either followup.period
or study.duration
.
study.duration
defines the total study duration in study designs with a variable follow-up period. The total study duration is defined as the length of time from the enrollment of the first patient to the discontinuation of the last patient.
dropout.dist
defines the dropout distribution.
dropout.dist.par
defines the parameters of the dropout distribution.
Several Design
objects can be added to a DataModel
object.
For more information about the Design
object, see the package’s documentation Design.
A convienient way to model non-uniform enrollment is to use a beta distribution (BetaDist
). If enroll.dist = "BetaDist"
, the enroll.dist.par
should contain the parameter of the beta distribution (a
and b
). These parameters must be derived according to the expected enrollment at a specific timepoint. For example, if half the patients are expected to be enrolled at 75% of the enrollment period, the beta distribution is a Beta(log(0.5)/log(0.75), 1)
. Generally, let q
be the proportion of enrolled patients at 100p
% of the enrollment period, the Beta distribution can be derived as follows:
If q < p
, the Beta distribution is Beta(a,1)
with a = log(q) / log(p)
If q > p
, the Beta distribution is Beta (1,b)
with b = log(1-q) / log(1-p)
Otherwise the Beta distribution is Beta(1,1)
Examples of Design
objects:
Specify parameters of the enrollment and dropout processes with a uniform enrollment distribution and exponential dropout distribution:
Analysis models define statistical methods (e.g., significance tests or descriptive statistics) that are applied to the study data in a clinical trial.
An analysis model can be initialized using the following command:
It is highly recommended to use this command to initialize an analysis model as it will simplify the process of specifying components of the data model, including the MultAdj
, MultAdjProc
, MultAdjStrategy
, Test
, Statistic
objects.
After an AnalysisModel
object has been initialized, components of the analysis model can be specified by adding objects to the model using the ‘+’ operator as shown below.
# Analysis model
case.study1.analysis.model = AnalysisModel() +
Test(id = "Placebo vs treatment",
samples = samples("Placebo", "Treatment"),
method = "TTest") +
Statistic(id = "Mean Treatment",
method = "MeanStat",
samples = samples("Treatment"))
Test
objectThis object specifies a significance test that will be applied to one or more samples defined in a data model. A Test
object is defined by the following four arguments:
id
defines the test’s unique ID (label).
method
defines the significance test.
samples
defines the IDs of the samples (defined in the data model) that the significance test is applied to.
par
defines the parameter(s) of the statistical test.
Several commonly used significance tests are already implemented in the Mediana package. In addition, the user can easily define custom significance tests (see the dedicated vignette vignette("custom-functions", package = "Mediana")
). The built-in tests are listed below along with the required parameters that need to be included in the par
argument:
TTest
: perform the two-sample t-test between the two samples defined in the samples
argument. Optional parameter: larger
(Larger value is expected in the second sample (TRUE
or FALSE
)).
TTestNI
: perform the non-inferiority two-sample t-test between the two samples defined in the samples
argument. Required parameter: margin
(positive non-inferiority margin). Optional parameter: larger
(Larger value is expected in the second sample (TRUE
or FALSE
)).
WilcoxTest
: perform the Wilcoxon-Mann-Whitney test between the two samples defined in the samples
argument. Optional parameter: larger
(Larger value is expected in the second sample (TRUE
or FALSE
)).
PropTest
: perform the two-sample test for proportions between the two samples defined in the samples
argument. Optional parameter: yates
(Yates’ continuity correction flag that is set to TRUE
or FALSE
) and larger
(Larger value is expected in the second sample (TRUE
or FALSE
)).
PropTestNI
: perform the non-inferiority two-sample test for proportions between the two samples defined in the samples
argument. Required parameter: margin
(positive non-inferiority margin). Optional parameter: yates
(Yates’ continuity correction flag that is set to TRUE
or FALSE
) and larger
(Larger value is expected in the second sample (TRUE
or FALSE
)).
FisherTest
: perform the Fisher exact test between the two samples defined in the samples
argument. Optional parameter: larger
(Larger value is expected in the second sample (TRUE
or FALSE
)).
GLMPoissonTest
: perform the Poisson regression test between the two samples defined in the samples
argument. Optional parameter: larger
(Larger value is expected in the second sample (TRUE
or FALSE
)).
GLMNegBinomTest
: perform the Negative-binomial regression test between the two samples
defined in the samples
argument. Optional parameter: larger
(Larger value is expected in the second sample (TRUE
or FALSE
)).
LogrankTest
: perform the Log-rank test between the two samples defined in the samples
argument. Optional parameter: larger
(Larger value is expected in the second sample (TRUE
or FALSE
)).
OrdinalLogisticRegTest
: perform an ordinal logistic regression test between the two samples defined in the samples
argument. Optional parameter: larger
(Larger value is expected in the second sample (TRUE
or FALSE
)).
It needs to be noted that the significance tests listed above are implemented as one-sided tests and thus the sample order in the samples
argument is important. In particular, the Mediana package assumes by default that a numerically larger value of the endpoint is expected in Sample 2 compared to Sample 1. Suppose, for example, that a higher treatment response indicates a beneficial effect (e.g., higher improvement rate). In this case Sample 1 should include control patients whereas Sample 2 should include patients allocated to the experimental treatment arm. The sample order needs to be reversed if a beneficial treatment effect is associated with a lower value of the endpoint (e.g., lower blood pressure), or alternatively (from version 1.0.6), the optional parameters larger
must be set to FALSE to indicate that a larger value is expected on the first Sample.
Several Test
objects can be added to an AnalysisModel
object.
For more information about the Test
object, see the package’s documentation Test on the CRAN web site.
Examples of Test
objects:
Carry out the two-sample t-test:
# Placebo and Treatment samples were defined in the data model
Test(id = "Placebo vs treatment",
samples = samples("Placebo", "Treatment"),
method = "TTest")
Carry out the two-sample t-test with larger values expected in the first sample (from v1.0.6):
# Placebo and Treatment samples were defined in the data model
Test(id = "Placebo vs treatment",
samples = samples("Treatment", "Placebo"),
method = "TTest",
par = parameters(larger = FALSE))
Carry out the two-sample t-test for non-inferiority:
# Placebo and Treatment samples were defined in the data model
Test(id = "Placebo vs treatment",
samples = samples("Placebo", "Treatment"),
method = "TTestNI",
par = parameters(margin = 0.2))
Carry out the two-sample t-test with pooled samples:
Statistic
objectThis object specifies a descriptive statistic that will be computed based on one or more samples defined in a data model. A Statistic
object is defined by four arguments:
id
defines the descriptive statistic’s unique ID (label).
method
defines the type of statistic/method for computing the statistic.
samples
defines the samples (pre-defined in the data model) to be used for computing the statistic.
par
defines the parameter(s) of the statistic.
Several methods for computing descriptive statistics are already implemented in the Mediana package and the user can also define custom functions for computing descriptive statistics (see the dedicated vignette vignette("custom-functions", package = "Mediana")
). These methods are shown below along with the required parameters that need to be defined in the par
argument:
MedianStat
: compute the median of the sample defined in the samples
argument.
MeanStat
: compute the mean of the sample defined in the samples
argument.
SdStat
: compute the standard deviation of the sample defined in the samples
argument.
MinStat
: compute the minimum value in the sample defined in the samples
argument.
MaxStat
: compute the maximum value in the sample defined in the samples
argument.
DiffMeanStat
: compute the difference of means between the two samples defined in the samples
argument. Two samples must be defined.
EffectSizeContStat
: compute the effect size for a continuous endpoint. Two samples must be defined.
RatioEffectSizeContStat
: compute the ratio of two effect sizes for a continuous endpoint. Four samples must be defined.
PropStat
: generate the proportion of the sample defined in the samples
argument.
DiffPropStat
: compute the difference of the proportions between the two samples defined in the samples
argument. Two samples must be defined.
EffectSizePropStat
: compute the effect size for a binary endpoint. Two samples must be defined.
RatioEffectSizePropStat
: compute the ratio of two effect sizes for a binary endpoint. Four samples must be defined.
HazardRatioStat
: compute the hazard ratio of the two samples defined in the samples argument. Two samples must be defined. By default the Log-Rank method is used. Optional argument: method
taking as value Log-Rank
or Cox
.
EffectSizeEventStat
: compute the effect size for a survival endpoint (log of the HR. Two samples must be defined. Two samples must be defined. By default the Log-Rank method is used. Optional argument: method
taking as value Log-Rank
or Cox
.
RatioEffectSizeEventStat
: compute the ratio of two effect sizes for a survival endpoint based on the Log-Rank method. Four samples must be defined. By default the Log-Rank method is used. Optional argument: method
taking as value Log-Rank
or Cox
.
EventCountStat
: compute the number of events observed in the sample(s) defined in the samples
argument.
PatientCountStat
: compute the number of patients observed in the sample(s) defined in the samples
argument
Several Statistic
objects can be added to an AnalysisModel
object.
For more information about the Statistic
object, see the R documentation Statistic.
Examples of Statistic
objects:
Compute the mean of a single sample:
MultAdjProc
objectThis object specifies a multiplicity adjustment procedure that will be applied to the significance tests in order to protect the overall Type I error rate. A MultAdjProc
object is defined by three arguments:
proc
defines a multiplicity adjustment procedure.
par
defines the parameter(s) of the multiplicity adjustment procedure (optional).
tests
defines the specific tests (defined in the analysis model) to which the multiplicity adjustment procedure will be applied.
If no tests
are defined, the multiplicity adjustment procedure will be applied to all tests defined in the AnalysisModel
object.
Several commonly used multiplicity adjustment procedures are included in the Mediana package. In addition, the user can easily define custom multiplicity adjustments. The built-in multiplicity adjustments are defined below along with the required parameters that need to be included in the par
argument:
BonferroniAdj
: Bonferroni procedure. Optional parameter: weight
(vector of hypothesis weights).
HolmAdj
: Holm procedure. Optional parameter: weight
(vector of hypothesis weights).
HochbergAdj
: Hochberg procedure. Optional parameter: weight
(vector of hypothesis weights).
HommelAdj
: Hommel procedure. Optional parameter: weight
(vector of hypothesis weights).
FixedSeqAdj
: Fixed-sequence procedure.
ChainAdj
: Family of chain procedures. Required parameters: weight
(vector of hypothesis weights) and transition
(matrix of transition parameters).
FallbackAdj
: Fallback procedure. Required parameters: weight
(vector of hypothesis weights).
NormalParamAdj
: Parametric multiple testing procedure derived from a multivariate normal distribution. Required parameter: corr
(correlation matrix of the multivariate normal distribution). Optional parameter: weight
(vector of hypothesis weights).
ParallelGatekeepingAdj
: Family of parallel gatekeeping procedures. Required parameters: family
(vectors of hypotheses included in each family), proc
(vector of procedure names applied to each family), gamma
(vector of truncation parameters).
MultipleSequenceGatekeepingAdj
: Family of multiple-sequence gatekeeping procedures. Required parameters: family
(vectors of hypotheses included in each family), proc
(vector of procedure names applied to each family), gamma
(vector of truncation parameters).
MixtureGatekeepingAdj
: Family of mixture-based gatekeeping procedures. Required parameters: family
(vectors of hypotheses included in each family), proc
(vector of procedure names applied to each family), gamma
(vector of truncation parameters), serial
(matrix of indicators), parallel
(matrix of indicators).
Several MultAdjProc
objects can be added to an AnalysisModel
object using the ‘+’ operator or by grouping them into a MultAdj object.
For more information about the MultAdjProc
object, see the package’s documentation MultAdjProc.
Examples of MultAdjProc
objects:
Apply a multiplicity adjustment based on the chain procedure:
# Parameters of the chain procedure (equivalent to a fixed-sequence procedure)
# Vector of hypothesis weights
chain.weight = c(1, 0)
# Matrix of transition parameters
chain.transition = matrix(c(0, 1,
0, 0), 2, 2, byrow = TRUE)
# MultAdjProc
MultAdjProc(proc = "ChainAdj",
par = parameters(weight = chain.weight,
transition = chain.transition))
This procedure implementation is facilicated by the use of the FixedSeqAdj
method intoduced in version 1.0.4.
Apply a multiple-sequence gatekeeping procedure:
# Parameters of the multiple-sequence gatekeeping procedure
# Tests to which the multiplicity adjustment will be applied (defined in the AnalysisModel)
test.list = tests("Pl vs DoseH - ACR20",
"Pl vs DoseL - ACR20",
"Pl vs DoseH - HAQ-DI",
"Pl vs DoseL - HAQ-DI")
# Hypothesis included in each family (the number corresponds to the position of the test in the test.list vector)
family = families(family1 = c(1, 2),
family2 = c(3, 4))
# Component procedure of each family
component.procedure = families(family1 ="HolmAdj",
family2 = "HolmAdj")
# Truncation parameter of each family
gamma = families(family1 = 0.8,
family2 = 1)
# MultAdjProc
MultAdjProc(proc = "MultipleSequenceGatekeepingAdj",
par = parameters(family = family,
proc = component.procedure,
gamma = gamma),
tests = test.list)
MultAdjStrategy
objectThis object specifies a multiplicity adjustment strategy that can include several multiplicity adjustment procedures. A multiplicity adjustment strategy may be defined when the same Clinical Scenario Evaluation approach is applied to several clinical trials.
A MultAdjStrategy
object serves as a wrapper for several MultAdjProc
objects.
For more information about the MultAdjStrategy
object, see the package’s documentation MultAdjStrategy.
Example of a MultAdjStrategy
object:
Perform complex multiplicity adjustments based on gatekeeping procedures in two clinical trials with three endpoints:
# Parallel gatekeeping procedure parameters
family = families(family1 = c(1),
family2 = c(2, 3))
component.procedure = families(family1 ="HolmAdj",
family2 = "HolmAdj")
gamma = families(family1 = 0.8,
family2 = 1)
# Multiple sequence gatekeeping procedure parameters for Trial A
mult.adj.trialA = MultAdjProc(proc = "ParallelGatekeepingAdj",
par = parameters(family = family,
proc = component.procedure,
gamma = gamma),
tests = tests("Trial A Pla vs Trt End1",
"Trial A Pla vs Trt End2",
"Trial A Pla vs Trt End3"))
mult.adj.trialB = MultAdjProc(proc = "ParallelGatekeepingAdj",
par = parameters(family = family,
proc = component.procedure,
gamma = gamma),
tests = tests("Trial B Pla vs Trt End1",
"Trial B Pla vs Trt End2",
"Trial B Pla vs Trt End3"))
# Analysis model
analysis.model = AnalysisModel() +
MultAdjStrategy(mult.adj.trialA, mult.adj.trialB) +
# Tests for study A
Test(id = "Trial A Pla vs Trt End1",
method = "PropTest",
samples = samples("Trial A Plac End1", "Trial A Trt End1")) +
Test(id = "Trial A Pla vs Trt End2",
method = "TTest",
samples = samples("Trial A Plac End2", "Trial A Trt End2")) +
Test(id = "Trial A Pla vs Trt End3",
method = "TTest",
samples = samples("Trial A Plac End3", "Trial A Trt End3")) +
# Tests for study B
Test(id = "Trial B Pla vs Trt End1",
method = "PropTest",
samples = samples("Trial B Plac End1", "Trial B Trt End1")) +
Test(id = "Trial B Pla vs Trt End2",
method = "TTest",
samples = samples("Trial B Plac End2", "Trial B Trt End2")) +
Test(id = "Trial B Pla vs Trt End3",
method = "TTest",
samples = samples("Trial B Plac End3", "Trial B Trt End3"))
MultAdj
objectThis object can be used to combine several MultAdjProc
or MultAdjStrategy
objects and add them as a single object to an AnalysisModel
object . This object is provided mainly for convenience and its use is optional. Alternatively, MultAdjProc
or MultAdjStrategy
objects can be added to an AnalysisModel
object incrementally using the ‘+’ operator.
For more information about the MultAdj
object, see the package’s documentation MultAdj.
Example of a MultAdj
object:
Perform Clinical Scenario Evaluation to compare three candidate multiplicity adjustment procedures:
# Multiplicity adjustments to compare
mult.adj1 = MultAdjProc(proc = "BonferroniAdj")
mult.adj2 = MultAdjProc(proc = "HolmAdj")
mult.adj3 = MultAdjProc(proc = "HochbergAdj")
# Analysis model
analysis.model = AnalysisModel() +
MultAdj(mult.adj1, mult.adj2, mult.adj3) +
Test(id = "Pl vs Dose L",
samples = samples("Placebo", "Dose L"),
method = "TTest") +
Test(id = "Pl vs Dose M",
samples = samples ("Placebo", "Dose M"),
method = "TTest") +
Test(id = "Pl vs Dose H",
samples = samples("Placebo", "Dose H"),
method = "TTest")
# Note that the code presented above is equivalent to:
analysis.model = AnalysisModel() +
mult.adj1 +
mult.adj2 +
mult.adj3 +
Test(id = "Pl vs Dose L",
samples = samples("Placebo", "Dose L"),
method = "TTest") +
Test(id = "Pl vs Dose M",
samples = samples ("Placebo", "Dose M"),
method = "TTest") +
Test(id = "Pl vs Dose H",
samples = samples("Placebo", "Dose H"),
method = "TTest")
Evaluation models are used within the Mediana package to specify the success criteria or metrics for evaluating the performance of the selected clinical scenario (combination of data and analysis models).
An evaluation model can be initialized using the following command:
It is highly recommended to use this command to initialize an evaluation model because it simplifies the process of specifying components of the evaluation model such as Criterion
objects.
After an EvaluationModel
object has been initialized, components of the evaluation model can be specified by adding objects to the model using the ‘+’ operator as shown below.
# Evaluation model
case.study1.evaluation.model = EvaluationModel() +
Criterion(id = "Marginal power",
method = "MarginalPower",
tests = tests("Placebo vs treatment"),
labels = c("Placebo vs treatment"),
par = parameters(alpha = 0.025)) +
Criterion(id = "Average Mean",
method = "MeanSumm",
statistics = statistics("Mean Treatment"),
labels = c("Average Mean Treatment"))
Criterion
objectThis object specifies the success criteria that will be applied to a clinical scenario to evaluate the performance of selected analysis methods. A Criterion
object is defined by six arguments:
id
defines the criterion’s unique ID (label).
method
defines the criterion.
tests
defines the IDs of the significance tests (defined in the analysis model) that the criterion is applied to.
statistics
defines the IDs the descriptive statistics (defined in the analysis model) that the criterion is applied to.
par
defines the parameter(s) of the criterion.
label
defines the label(s) of the criterion values (the label(s) will be used in the simulation report).
Several commonly used success criteria are implemented in the Mediana package. The user can also define custom significance criteria. The built-in success criteria are listed below along with the required parameters that need to be included in the par
argument:
MarginalPower
: compute the marginal power of all tests included in the test
argument. Required parameter: alpha
(significance level used in each test).
WeightedPower
: compute the weighted power of all tests included in the test
argument. Required parameters: alpha
(significance level used in each test) and weight
(vector of weights assigned to the significance tests).
DisjunctivePower
: compute the disjunctive power (probability of achieving statistical significance in at least one test included in the test
argument). Required parameter: alpha
(significance level used in each test).
ConjunctivePower
: compute the conjunctive power (probability of achieving statistical significance in all tests included in the test
argument). Required parameter: alpha
(significance level used in each test).
ExpectedRejPower
: compute the expected number of statistical significant tests. Required parameter: alpha
(significance level used in each test).
Several Criterion
objects can be added to an EvaluationModel
object.
For more information about the Criterion
object, see the package’s documentation Criterion.
If a certain success criterion is not implemented in the Mediana package, the user can create a custom function and use it within the package (see the dedicated vignette vignette("custom-functions", package = "Mediana")
).
Examples of Criterion
objects:
Compute marginal power with alpha = 0.025:
Criterion(id = "Marginal power",
method = "MarginalPower",
tests = tests("Placebo vs treatment"),
labels = c("Placebo vs treatment"),
par = parameters(alpha = 0.025))
Compute weighted power with alpha = 0.025 and unequal test-specific weights:
Criterion(id = "Weighted power",
method = "WeightedPower",
tests = tests("Placebo vs treatment - Endpoint 1",
"Placebo vs treatment - Endpoint 2"),
labels = c("Weighted power"),
par = parameters(alpha = 0.025,
weight = c(2/3, 1/3)))
Compute disjunctive power with alpha = 0.025:
Clinical Scenario Evaluation (CSE) is performed based on the data, analysis and evaluation models as well as simulation parameters specified by the user. The simulation parameters are defined using the SimParameters
object.
SimParameters
objectThe SimParameters
object is a required argument of the CSE
function and has the following arguments:
n.sims
defines the number of simulations.seed
defines the seed to be used in the simulations.proc.load
defines the processor load in parallel computations.The proc.load
argument is used to define the number of processor cores dedicated to the simulations. A numeric value can be defined as well as character value which automatically detects the number of cores:
low
: 1 processor core.
med
: Number of available processor cores / 2.
high
: Number of available processor cores 1.
full
: All available processor cores.
Examples of SimParameters
object specification:
Perform 10000 simulations using all available processor cores:
Perform 10000 simulations using 2 processor cores:
CSE
functionThe CSE
function is invoked to runs simulations under the Clinical Scenario Evaluation approach. This function uses four arguments:
data
defines a DataModel
object.
analysis
defines an AnalysisModel
object.
evaluation
defines an EvaluationModel
object.
simulation
defines a SimParameters
object.
The following example illustrates the use of the CSE
function:
# Outcome parameter set 1
outcome1.placebo = parameters(mean = 0, sd = 70)
outcome1.treatment = parameters(mean = 40, sd = 70)
# Outcome parameter set 2
outcome2.placebo = parameters(mean = 0, sd = 70)
outcome2.treatment = parameters(mean = 50, sd = 70)
# Data model
case.study1.data.model = DataModel() +
OutcomeDist(outcome.dist = "NormalDist") +
SampleSize(c(50, 55, 60, 65, 70)) +
Sample(id = "Placebo",
outcome.par = parameters(outcome1.placebo, outcome2.placebo)) +
Sample(id = "Treatment",
outcome.par = parameters(outcome1.treatment, outcome2.treatment))
# Analysis model
case.study1.analysis.model = AnalysisModel() +
Test(id = "Placebo vs treatment",
samples = samples("Placebo", "Treatment"),
method = "TTest")
# Evaluation model
case.study1.evaluation.model = EvaluationModel() +
Criterion(id = "Marginal power",
method = "MarginalPower",
tests = tests("Placebo vs treatment"),
labels = c("Placebo vs treatment"),
par = parameters(alpha = 0.025))
# Simulation Parameters
case.study1.sim.parameters = SimParameters(n.sims = 1000, proc.load = 2, seed = 42938001)
# Perform clinical scenario evaluation
case.study1.results = CSE(case.study1.data.model,
case.study1.analysis.model,
case.study1.evaluation.model,
case.study1.sim.parameters)
Once Clinical Scenario Evaluation-based simulations have been run, the CSE
object returned by the CSE
function contains a list with the following components:
simulation.results
: a data frame containing the results of the simulations for each scenario.
analysis.scenario.grid
: a data frame containing the grid of the combination of data and analysis scenarios.
data.structure
: a list containing the data structure according to the DataModel
object.
analysis.structure
: a list containing the analysis structure according to the AnalysisModel
object.
evaluation.structure
: a list containing the evaluation structure according to the EvaluationModel
object.
sim.parameters
: a list containing the simulation parameters according to SimParameters
object.
timestamp
: a list containing information about the start time, end time and duration of the simulation runs.
The simulation results can be summarized in the R console using the summary
function:
A Microsoft Word-based simulation report can be generated from the simulation results produced by the CSE
function using the GenerateReport
function, see Simulation report.
The Mediana R package uses the officer R package package to generate a Microsoft Word-based report that summarizes the results of Clinical Scenario Evaluation-based simulations.
The user can easily customize this simulation report by adding a description of the project as well as labels to each scenario, including data scenarios (sample size, outcome distribution parameters, design parameters) and analysis scenarios (multiplicity adjustment). The user can also customize the report’s structure, e.g., create sections and subsections within the report and specify how the rows will be sorted within each table.
In order to customize the report, the user has to use a PresentationModel
object described below.
Once a PresentationModel
object has been defined, the GenerateReport
function can be called to generate a Clinical Scenario Evaluation report.
A presentation model can be initialized using the following command
Initialization with this command is highly recommended as it will simplify the process of adding related objects, e.g., the Project
, Section
, Subsection
, Table
, CustomLabel
objects.
Once the PresentationModel
object has been initialized, specific objects can be added by simply using the ‘+’ operator as in data, analysis and evaluation models.
Project
objectThis object specifies a description of the project. The Project
object is defined by three optional arguments:
username
defines the username to be included in the report (by default, the username is “[Unknown User]”).
title
defines the project’s in the report (the default value is “[Unknown title]”).
description
defines the project’s description (the default value is “[No description]”).
This information will be added in the report generated using the GenerateReport
function.
A single object of the Project
class can be added to an object of the PresentationModel
class.
A simple Project
object can be created as follows:
Section
objectThis object specifies the sections that will be created within the simulation report. A Section
object is defined by a single argument:
by
defines the rules for setting up sections.The by
argument can contain several parameters from the following list:
sample.size
: a separate section will be created for each sample size.
event
: a separate section will be created for each event count.
outcome.parameter
: a separate section will be created for each outcome parameter scenario.
design.parameter
: a separate section will be created for each design parameter scenario.
multiplicity.adjustment
: a separate section will be created for each multiplicity adjustment scenario.
Note that, if a parameter is defined in the by
argument, it must be defined only in this object (i.e., neither in the Subection
object nor in the Table
object).
A single object of the Section
class can be added to an object of the PresentationModel
class.
A Section
object can be defined as follows:
Create a separate section within the report for each outcome parameter scenario:
Create a separate section for each unique combination of the sample size and outcome parameter scenarios:
Subsection
objectThis object specifies the rules for creating subsections within the simulation report. A Subsection
object is defined by a single argument:
by
defines the rules for creating subsections.The by
argument can contain several parameters from the following list:
sample.size
: a separate subsection will be created for each sample size.
event
: a separate subsection will be created for each number of events.
outcome.parameter
: a separate subsection will be created for each outcome parameter scenario.
design.parameter
: a separate subsection will be created for each design parameter scenario.
multiplicity.adjustment
: a separate subsection will be created for each multiplicity adjustment scenario.
As before, if a parameter is defined in the by
argument, it must be defined only in this object (i.e., neither in the Section
object nor in the Table
object).
A single object of the Subsection
class can be added to an object of the PresentationModel
class. #### Examples
Subsection
objects can be set up as follows:
Create a separate subsection for each sample size scenario:
Create a separate subsection for each unique combination of the sample size and outcome parameter scenarios:
Table
objectThis object specifies how the summary tables will be sorted within the report. A Table
object is defined by a single argument:
by
defines how the tables of the report will be sorted.The by
argument can contain several parameters, the value must be contain in the following list:
sample.size
: the tables will be sorted by the sample size.
event
: the tables will be sorted by the number of events.
outcome.parameter
: the tables will be sorted by the outcome parameter scenario.
design.parameter
: the tables will be sorted by the design parameter scenario.
multiplicity.adjustment
: the tables will be sorted by the multiplicity adjustment scenario.
If a parameter is defined in the by
argument it must be defined only in this object (i.e., neither in the Section
object nor in the Subsection
object).
A single object of class Table
can be added to an object of class PresentationModel
.
Examples of Table
objects:
Create a summary table sorted by sample size scenarios:
Create a summary table sorted by sample size and outcome parameter scenarios:
CustomLabel
objectThis object specifies the labels that will be assigned to sets of parameter values or simulation scenarios. These labels will be used in the section and subsection titles of the Clinical Scenario Evaluation Report as well as in the summary tables. A CustomLabel
object is defined by two arguments:
param
defines a parameter (scenario) to which the current set of labels will be assigned.
label
defines the label(s) to assign to each value of the parameter.
The param
argument can contain several parameters from the following list:
sample.size
: labels will be applied to sample size values.
event
: labels will be applied to number of events values.
outcome.parameter
: labels will be applied to outcome parameter scenarios.
design.parameter
: labels will be applied to design parameter scenarios.
multiplicity.adjustment
: labels will be applied to multiplicity adjustment scenarios.
Several objects of the CustomLabel
class can be added to an object of the PresentationModel
class.
Examples of CustomLabel
objects:
Assign a custom label to the sample size values:
Assign a custom label to the outcome parameter scenarios:
GenerateReport
functionThe Clinical Scenario Evaluation Report is generated using the GenerateReport
function. This function has four arguments:
presentation.model
defines a PresentationModel
object.
cse.result
defines a CSE
object returned by the CSE function.
report.filename
defines the filename of the Word-based report generated by this function.
report.template
defines a Word-based template (it is an optional argument).
The GenerateReport
function requires the officer R package package to generate a Word-based simulation report. Optionally, a custom template can be selected by defining report.template
, this argument specifies the name of a Word document located in the working directory.
The Word-based simulation report is structured as follows:
Design
object has been defined)Event
object has been defined)Section
object has been defined)
Subsection
object has been defined)This example illustrates the use of the GenerateReport
function:
# Define a presentation model
case.study1.presentation.model = PresentationModel() +
Section(by = "outcome.parameter") +
Table(by = "sample.size") +
CustomLabel(param = "sample.size",
label= paste0("N = ",c(50, 55, 60, 65, 70))) +
CustomLabel(param = "outcome.parameter",
label=c("Standard 1", "Standard 2"))
# Report Generation
GenerateReport(presentation.model = case.study1.presentation.model,
cse.results = case.study1.results,
report.filename = "Case study 1 (normally distributed endpoint).docx")
These binaries (installable software) and packages are in development.
They may not be fully stable and should be used with caution. We make no claims about them.