--- title: "Propensity Score-Integrated Survival Inference in Randomized Controlled Trials (RCTs) with Augmenting Control Arm" date: "`r Sys.Date()`" output: rmarkdown::html_vignette vignette: > %\VignetteIndexEntry{Propensity Score-Integrated Survival Inference in Randomized Controlled Trials (RCTs) with Augmenting Control Arm} %\VignetteEngine{knitr::rmarkdown} %\VignetteEncoding{UTF-8} --- ```{r, eval=T, echo=FALSE} suppressMessages(require(psrwe, quietly = TRUE)) options(digits = 3) set.seed(1000) ```
## Introduction In the **psrwe**, PS-integrated survival analyses in randomized controlled trials (RCTs) with augmenting control arm (Chen, et al., to be submitted) are also implemented in three functions: * `psrwe_survkm()` for treatment effect test (Com-Nougue, et al., 1993). * `psrwe_survlrk()` for log-rank test (Klein and Moeschberger, 2003; Peto and Peto, 1972). * `psrwe_survrmst()` for restricted mean survival time (RMST) test (Royston and Parmar, 2013; Uno, et al., 2014). These tests are non-parametric approaches for comparing two treatments with time-to-event endpoints. Therefore, these tests are only implemented for RCTs with augmenting control arm. Similar with the approaches: PSPP (Wang, et al., 2019), PSCL (Wang, et al., 2020), and PSKM (Chen, et al., 2022), the PS-integrated study design functions, `psrwe_est()` and `psrwe_borrow()`, below estimate PS model, set borrowing parameters, and determine discounting parameters for borrowing information for a two-arm RCT with augmenting control arm from RWD. ```{r, eval=T, echo=TRUE} data(ex_dta_rct) dta_ps_rct <- psrwe_est(ex_dta_rct, v_covs = paste("V", 1:7, sep = ""), v_grp = "Group", cur_grp_level = "current", v_arm = "Arm", ctl_arm_level = "control", ps_method = "logistic", nstrata = 5, stra_ctl_only = FALSE) ps_bor_rct <- psrwe_borrow(dta_ps_rct, total_borrow = 30) ```
## PS-integrated treatment effect test Similar with the single arm study example (in **psrwe/demo/sec_4_4_ex.r** and `demo("sec_4_5_ex", package = "psrwe")`), the code below evaluates two-arm RCT. The results show the treatment effect which is the survival difference between two arms at one year or 365 days. ```{r, eval=T, echo=TRUE} rst_km_rct <- psrwe_survkm(ps_bor_rct, pred_tp = 365, v_time = "Y_Surv", v_event = "Status") rst_km_rct ``` The estimated PSKM curves with confidence intervals can be visualized below. ```{r, echo=TRUE, fig.width=6, fig.height=5} plot(rst_km_rct, xlim = c(0, 730)) ``` The inference is based on the treatment effect $S_{trt}(\tau) - S_{ctl}(\tau)$ at $\tau = 365$ days where $S_{trt}$ and $S_{ctl}$ are the survival probabilities of the treatment and control arms, respectively. i.e., the example tests $$ H_0: S_{trt}(\tau) - S_{ctl}(\tau) \leq 0 \quad \mbox{vs.} \quad H_a: S_{trt}(\tau) - S_{ctl}(\tau) > 0 . $$ The outcome analysis can be summarized below. Note that this is an one-sided test. ```{r, eval=T, echo=TRUE} oa_km_rct <- psrwe_outana(rst_km_rct, alternative = "greater") oa_km_rct ``` The details of estimates for each arm can be printed via the `print()` function with the option `show_rct = TRUE`. ```{r, eval=T, echo=TRUE} print(oa_km_rct, show_rct = TRUE) ``` As the **survival** package, the results of other time points can be also predicted via the `summary()` with the option `pred_tps`. ```{r, eval=T, echo=TRUE} summary(oa_km_rct, pred_tps = c(180, 365)) ```
## PS-integrated log-rank test The log-rank test is another way to compare two treatments of time-to-event endpoint. Similar the PSKM for the two-arm test above, the function `psrwe_survlrk()` computes the statistic for each distinctive time point beased on the observed data then returns all necessary results for the down-streatm analyses such as tests and confidence intervals. ```{r, eval=T, echo=TRUE} rst_lrk <- psrwe_survlrk(ps_bor_rct, pred_tp = 365, v_time = "Y_Surv", v_event = "Status") rst_lrk ``` The inference is based on the log-rank method to test whether two survival distributions are different from each other. The example tests $$ H_0: S_{trt}(t) = S_{ctl}(t) \quad \mbox{vs.} \quad H_a: S_{trt}(t) \neq S_{ctl}(t) 0 $$ for all $t \leq \tau$ where $\tau = 365$ days. The outcome analysis can be summarized below. ```{r, eval=T, echo=TRUE} oa_lrk <- psrwe_outana(rst_lrk) oa_lrk ``` The details of estimates for each arm can be printed via the `print()` function with the option `show_rct = TRUE`. ```{r, eval=T, echo=TRUE} print(oa_lrk, show_details = TRUE) ``` As the **survival** package, the results of other time points can be also predicted via the `summary()` with the option `pred_tps`. ```{r, eval=T, echo=TRUE} summary(oa_lrk, pred_tps = c(180, 365)) ```
## PS-integrated restricted mean survival time (RMST) test The restricted means survival time (RMST) between two treatments is to test whether areas under two survival distributions (AUC) are different from each other. Similar the log-rank test above, the function `psrwe_survrmst()` computes the statistic for each distinctive time point beased on the observed data then returns all necessary results for the down-streatm analyses such as tests and confidence intervals. ```{r, eval=T, echo=TRUE} rst_rmst <- psrwe_survrmst(ps_bor_rct, pred_tp = 365, v_time = "Y_Surv", v_event = "Status") rst_rmst ``` The inference is based on the to compare whether AUCs are different from each other. The example tests $$ H_0: \int_0^{\tau} S_{trt}(t) dt = \int_0^{\tau} S_{ctl}(t) dt \quad \mbox{vs.} \quad H_a: \int_0^{\tau} S_{trt}(t) dt \neq \int_0^{\tau} S_{ctl}(t) dt $$ where $\tau = 365$ days. The outcome analysis can be summarized below. Note that this is a two-sided test. ```{r, eval=T, echo=TRUE} oa_rmst <- psrwe_outana(rst_rmst) oa_rmst ``` The details of estimates for each arm can be printed via the `print()` function with the option `show_rct = TRUE`. ```{r, eval=T, echo=TRUE} print(oa_rmst, show_details = TRUE) ``` As the **survival** package, the results of other time points can be also predicted via the `summary()` with the option `pred_tps`. ```{r, eval=T, echo=TRUE} summary(oa_rmst, pred_tps = c(180, 365)) ```
## Demo examples The scripts in "**psrwe/demo/sec_4_5_ex.r**", "**psrwe/demo/sec_4_6_ex.r**", and "**psrwe/demo/sec_4_7_ex.r**" source files have the full examples for the PS-integrated survival analyses which can be run via the `demo("sec_4_5_ex", package = "psrwe")`, `demo("sec_4_6_ex", package = "psrwe")`, and `demo("sec_4_7_ex", package = "psrwe")`, respectively. Two Jackknife standard errors are also demonstrated for each test method. Note that Jackknife standard errors may take a while to finish.
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