Methods for Meta–Analyses of Rare Events, Sparse Data, and Heterogeneity

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Methods for Meta–Analyses of Rare Events, Sparse Data, and Heterogeneity Utah State University DigitalCommons@USU All Graduate Theses and Dissertations Graduate Studies 5-2019 Methods for Meta–Analyses of Rare Events, Sparse Data, and Heterogeneity Brinley Zabriskie Utah State University Follow this and additional works at: https://digitalcommons.usu.edu/etd Part of the Mathematics Commons Recommended Citation Zabriskie, Brinley, "Methods for Meta–Analyses of Rare Events, Sparse Data, and Heterogeneity" (2019). All Graduate Theses and Dissertations. 7491. https://digitalcommons.usu.edu/etd/7491 This Dissertation is brought to you for free and open access by the Graduate Studies at DigitalCommons@USU. It has been accepted for inclusion in All Graduate Theses and Dissertations by an authorized administrator of DigitalCommons@USU. For more information, please contact [email protected]. METHODS FOR META{ANALYSES OF RARE EVENTS, SPARSE DATA, AND HETEROGENEITY by Brinley Zabriskie A dissertation submitted in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY in Mathematical Sciences (Statistics Specialization) Approved: Chris Corcoran, Sc.D. Adele Cutler, Ph.D. Major Professor Committee Member John Stevens, Ph.D. David Brown, Ph.D. Committee Member Committee Member Tyler Brough, Ph.D. Richard S. Inouye, Ph.D. Committee Member Vice Provost for Graduate Studies UTAH STATE UNIVERSITY Logan, Utah 2019 ii Copyright © Brinley Zabriskie 2019 All Rights Reserved iii ABSTRACT Methods for Meta{Analyses of Rare Events, Sparse Data, and Heterogeneity by Brinley Zabriskie, Doctor of Philosophy Utah State University, 2019 Major Professor: Dr. Chris Corcoran Department: Mathematics and Statistics The increasingly widespread use of meta{analysis has led to growing interest in meta{analytic methods for rare events and sparse data. Conventional approaches tend to perform very poorly in such settings. Recent work in this area has provided options for sparse data, but these are still often hampered when heterogeneity across the available studies differs based on treatment group. We propose several new exact methods that accommodate this common contingency, providing more reliable statistical tests when such patterns on heterogeneity are observed. First, we develop a permutation{based approach that can also be used as a basis for computing exact confidence intervals when estimating the effect size. Second, we extend the permutation{based approach to the network meta{analysis setting. Third, we develop a new exact confidence distribution approach for effect size estimation. We show these new methods perform markedly better than traditional methods when events are rare, and heterogeneity is present. (264 pages) iv PUBLIC ABSTRACT Methods for Meta{Analyses of Rare Events, Sparse Data, and Heterogeneity Brinley Zabriskie The vast and complex wealth of information available to researchers often leads to a systematic review, which involves a detailed and comprehensive plan and search strategy with the goal of identifying, appraising, and synthesizing all relevant studies on a particular topic. A meta{analysis, conducted ideally as part of a comprehensive systematic review, statistically synthesizes evidence from multiple independent studies to produce one overall conclusion. The increasingly widespread use of meta{analysis has led to growing interest in meta{analytic methods for rare events and sparse data. Conventional approaches tend to perform very poorly in such settings. Recent work in this area has provided options for sparse data, but these are still often hampered when heterogeneity across the available studies differs based on treatment group. Heterogeneity arises when participants in a study are more correlated than participants across studies, often stemming from differences in the administration of the treatment, study design, or measurement of the outcome. We propose several new exact methods that accommodate this common contingency, providing more reliable statistical tests when such patterns on heterogeneity are observed. First, we develop a permutation{based approach that can also be used as a basis for computing exact confidence intervals when estimating the effect size. Second, we extend the permutation{based approach to the network meta{analysis setting. Third, we develop a new exact confidence distribution approach for effect size estimation. We show these new methods perform markedly better than traditional methods when events are rare, and heterogeneity is present. v ACKNOWLEDGMENTS I would like to first thank Dr. Chris Corcoran for providing me the opportunity to pursue this degree and for his time, advice, and encouragement. I am also grateful for the teaching opportunities he gave me throughout my time at Utah State University. Dr. Corcoran has been very influential in my career development. I would also like to thank my committee members, Drs. Adele Cutler, John Stevens, Dave Brown, and Tyler Brough for their time, input, and assistance. Additionally, the faculty, staff, and students in the Department of Mathematics and Statistics have made my time here enjoyable and memorable. I would also like to thank the co{founders of Cytel Inc., Drs. Cyrus Mehta and Nitin Patel, whose pioneering advancements made this work possible. I greatly appreciate Dr. Pralay Senchaudhuri, Senior Vice President for Research & Development at Cytel Inc., who has taken the time to provide invaluable advice throughout this process. I would also like to thank software specialist Sumit Singh who provided technical support. This work would also not have been possible without the Center for High Performance Computing at the University of Utah. I am grateful for their resources and technical assistance. Lastly, I am grateful for my family for their assistance, support, and encouragement. Brinley Zabriskie vi CONTENTS Page ABSTRACT......................................... iii PUBLIC ABSTRACT.................................... iv ACKNOWLEDGMENTS.................................. v LIST OF TABLES...................................... ix LIST OF FIGURES..................................... x 1 INTRODUCTION TO META{ANALYSIS METHODS FOR RARE EVENTS AND HETEROGENEITY................................. 1 1.1 Background....................................1 1.2 Common Statistical Methods for Meta{Analyses...............4 1.3 Common Statistical Methods for Meta{Analyses of Rare Events......8 1.4 Novel Statistical Methods for Meta{Analyses of Rare Events........ 13 1.5 Summary of the Remaining Chapters..................... 16 2 EXACT META{ANALYSIS FOR RARE EVENTS AND HETEROGENEITY . 18 2.1 Background.................................... 18 2.2 Methodology................................... 19 2.2.1 Exact Conditional Logistic Regression................. 19 2.2.2 Exact Conditional Logistic Regression for Correlated Data..... 22 2.2.3 Exact Estimation Method........................ 26 2.2.4 Network Algorithm............................ 29 2.3 Innovation.................................... 34 2.3.1 Exact Test: Variation of Treatment Level Within Study....... 34 2.3.2 Exact Test: Variation of Correlation Structure Among Treatment Levels 36 2.3.3 Network Algorithm: Variation of Treatment Level Within Study.. 38 2.3.4 Network Algorithm: Variation of Correlation Structure Among Treat- ment Levels.............................. 40 2.4 Application.................................... 41 2.4.1 Simulation Study............................. 42 vii 2.4.1.1 Type I Error........................... 44 2.4.1.2 Bias................................ 46 2.4.1.3 Confidence Interval Coverage.................. 49 2.4.2 Illustrative Examples........................... 51 2.4.2.1 Stomach Ulcers......................... 51 2.4.2.2 Antibiotics............................ 54 2.4.3 Network Algorithm............................ 57 2.4.3.1 Original Exact Test for Correlated Data........... 57 2.4.3.2 Variation of Treatment Level Within Study.......... 68 2.4.3.3 Variation of Correlation Structure Among Treatment Levels 68 2.5 Conclusion.................................... 72 3 EXACT NETWORK META{ANALYSIS....................... 76 3.1 Background.................................... 76 3.1.1 Introduction and Terminology...................... 76 3.1.2 Basic Methods.............................. 80 3.1.3 Assumptions and Validity Considerations............... 82 3.2 Methodology and Innovation.......................... 83 3.3 Application.................................... 87 3.4 Conclusion.................................... 92 4 COMBINING CONFIDENCE DISTRIBUTIONS FOR RARE EVENT META{ ANALYSIS...................................... 93 4.1 Background.................................... 93 4.2 Methodology................................... 100 4.2.1 Confidence Distribution Definition................... 100 4.2.2 Combining Confidence Intervals as in Tian et al.(2009)....... 101 4.2.3 Combining p{value Functions as in Liu et al.(2014)......... 103 4.2.4 Combining p{values as in Fisher(1932)................ 105 4.3 Innovation.................................... 106 4.3.1 Modification 1: Use the Logit Function Under the General CD Frame- work without Weights........................ 107 4.3.2 Modification 2: Use the Logit Function Under the General CD Frame- work with Weights Defined by Liu et al.(2014).......... 108 viii 4.3.3 Modification 3: Use the Tian et al.(2009) Framework with Weights Defined by Liu et al.(2014)..................... 109 4.3.4 Summary................................. 109 4.4 Application.................................... 109 4.4.1 Simulation Results...........................
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