Using Bayesian statistics to estimate the likelihood a new trial will demonstrate the efficacy of a new treatment - Inserm - Institut national de la santé et de la recherche médicale Accéder directement au contenu
Article Dans Une Revue BMC Medical Research Methodology Année : 2017

Using Bayesian statistics to estimate the likelihood a new trial will demonstrate the efficacy of a new treatment

Résumé

BACKGROUND: The common frequentist approach is limited in providing investigators with appropriate measures for conducting a new trial. To answer such important questions and one has to look at Bayesian statistics. METHODS: As a worked example, we conducted a Bayesian cumulative meta-analysis to summarize the benefit of patient-specific instrumentation on the alignment of total knee replacement from previously published evidence. Data were sourced from Medline, Embase, and Cochrane databases. All randomised controlled comparisons of the effect of patient-specific instrumentation on the coronal alignment of total knee replacement were included. The main outcome was the risk difference measured by the proportion of failures in the control group minus the proportion of failures in the experimental group. Through Bayesian statistics, we estimated cumulatively over publication time of the trial results: the posterior probabilities that the risk difference was more than 5 and 10%; the posterior probabilities that given the results of all previous published trials an additional fictive trial would achieve a risk difference of at least 5%; and the predictive probabilities that observed failure rate differ from 5% across arms. RESULTS: Thirteen trials were identified including 1092 patients, 554 in the experimental group and 538 in the control group. The cumulative mean risk difference was 0.5% (95% CrI: -5.7%; +4.5%). The posterior probabilities that the risk difference be superior to 5 and 10% was less than 5% after trial #4 and trial #2 respectively. The predictive probability that the difference in failure rates was at least 5% dropped from 45% after the first trial down to 11% after the 13th. Last, only unrealistic trial design parameters could change the overall evidence accumulated to date. CONCLUSIONS: Bayesian probabilities are readily understandable when discussing the relevance of performing a new trial. It provides investigators the current probability that an experimental treatment be superior to a reference treatment. In case a trial is designed, it also provides the predictive probability that this new trial will reach the targeted risk difference in failure rates. TRIAL REGISTRATION: CRD42015024176 .
Fichier principal
Vignette du fichier
s12874-017-0401-x.pdf (871.26 Ko) Télécharger le fichier
Origine : Publication financée par une institution
Loading...

Dates et versions

inserm-02312357 , version 1 (11-10-2019)

Identifiants

Citer

David J Biau, Samuel Boulezaz, Laurent Casabianca, Moussa Hamadouche, Philippe Anract, et al.. Using Bayesian statistics to estimate the likelihood a new trial will demonstrate the efficacy of a new treatment. BMC Medical Research Methodology, 2017, 17 (1), pp.128. ⟨10.1186/s12874-017-0401-x⟩. ⟨inserm-02312357⟩
52 Consultations
50 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More