Bayesian design and conduct of phase II single-arm clinical trials with binary outcomes: a tutorial

The aim of phase II single-arm clinical trials of a new drug is to determine whether it has sufficient promising activity to warrant its further development. For the last several years Bayesian statistical methods have been proposed and used. Bayesian approaches are ideal for earlier phase trials as they take into account information that accrues during a trial. Predictive probabilities are then updated and so become more accurate as the trial progresses. Suitable priors can act as pseudo samples, which make small sample clinical trials more informative. Thus patients have better chances to receive better treatments. The goal of this paper is to provide a tutorial for statisticians who use Bayesian methods for the first time or investigators who have some statistical background. In addition, real data from three clinical trials are presented as examples to illustrate how to conduct a Bayesian approach for phase II single-arm clinical trials with binary outcomes.

Identifying adaptive genetic divergence among populations from genome scans

The identification of signatures of natural selection in genomic surveys has become an area of intense research, stimulated by the increasing ease with which genetic markers can be typed. Loci identified as subject to selection may be functionally important, and hence (weak) candidates for involvement in disease causation. They can also be useful in determining the adaptive differentiation of populations, and exploring hypotheses about speciation. Adaptive differentiation has traditionally been identified from differences in allele frequencies among different populations, summarised by an estimate of F-ST. Low outliers relative to an appropriate neutral population-genetics model indicate loci subject to balancing selection, whereas high outliers suggest adaptive (directional) selection. However, the problem of identifying statistically significant departures from neutrality is complicated by confounding effects on the distribution of F-ST estimates, and current methods have not yet been tested in large-scale simulation experiments. Here, we simulate data from a structured population at many unlinked, diallelic loci that are predominantly neutral but with some loci subject to adaptive or balancing selection. We develop a hierarchical-Bayesian method, implemented via Markov chain Monte Carlo (MCMC), and assess its performance in distinguishing the loci simulated under selection from the neutral loci. We also compare this performance with that of a frequentist method, based on moment-based estimates of F-ST. We find that both methods can identify loci subject to adaptive selection when the selection coefficient is at least five times the migration rate. Neither method could reliably distinguish loci under balancing selection in our simulations, even when the selection coefficient is twenty times the migration rate.

Longitudinal Poisson modeling: an application for CD4 counting in HIV-infected patients

In this paper, we present different ofrailtyo models to analyze longitudinal data in the presence of covariates. These models incorporate the extra-Poisson variability and the possible correlation among the repeated counting data for each individual. Assuming a CD4 counting data set in HIV-infected patients, we develop a hierarchical Bayesian analysis considering the different proposed models and using Markov Chain Monte Carlo methods. We also discuss some Bayesian discrimination aspects for the choice of the best model.

Bayesian Estimation for Performance Measures of Two Diagnostic Tests in the Presence of Verification Bias

Sensitivity and specificity are measures that allow us to evaluate the performance of a diagnostic test. In practice, it is common to have situations where a proportion of selected individuals cannot have the real state of the disease verified, since the verification could be an invasive procedure, as occurs with biopsy. This happens, as a special case, in the diagnosis of prostate cancer, or in any other situation related to risks, that is, not practicable, nor ethical, or in situations with high cost. For this case, it is common to use diagnostic tests based only on the information of verified individuals. This procedure can lead to biased results or workup bias. In this paper, we introduce a Bayesian approach to estimate the sensitivity and the specificity for two diagnostic tests considering verified and unverified individuals, a result that generalizes the usual situation based on only one diagnostic test.

A Bayesian Analysis in the Presence of Covariates for Multivariate Survival Data: An example of Application

In this paper, we introduce a Bayesian analysis for survival multivariate data in the presence of a covariate vector and censored observations. Different ""frailties"" or latent variables are considered to capture the correlation among the survival times for the same individual. We assume Weibull or generalized Gamma distributions considering right censored lifetime data. We develop the Bayesian analysis using Markov Chain Monte Carlo (MCMC) methods.

Predator-prey models: an application for the plankton dynamics of lake Geneva

In this paper we present a hierarchical Bayesian analysis for a predator-prey model applied to ecology considering the use of Markov Chain Monte Carlo methods. We consider the introduction of a random effect in the model and the presence of a covariate vector. An application to ecology is considered using a data set related to the plankton dynamics of lake Geneva for the year 1990. We also discuss some aspects of discrimination of the proposed models.

A useful empirical bayesian method to analyse industrial data from saturated factorial designs

The use of saturated two-level designs is very popular, especially in industrial applications where the cost of experiments is too high. Standard classical approaches are not appropriate to analyze data from saturated designs, since we could only get the estimates of the main factor effects and we would not have degrees of freedom to estimate the variance of the error. In this paper, we propose the use of empirical Bayesian procedures to get inferences for data obtained from saturated designs. The proposed methodology is illustrated assuming a simulated data set. © 2013 Growing Science Ltd. All rights reserved.

Essays on Bayesian Inference for Social Networks

This thesis presents Bayesian solutions to inference problems for three types of social network data structures: a single observation of a social network, repeated observations on the same social network, and repeated observations on a social network developing through time. A social network is conceived as being a structure consisting of actors and their social interaction with each other. A common conceptualisation of social networks is to let the actors be represented by nodes in a graph with edges between pairs of nodes that are relationally tied to each other according to some definition. Statistical analysis of social networks is to a large extent concerned with modelling of these relational ties, which lends itself to empirical evaluation. The first paper deals with a family of statistical models for social networks called exponential random graphs that takes various structural features of the network into account. In general, the likelihood functions of exponential random graphs are only known up to a constant of proportionality. A procedure for performing Bayesian inference using Markov chain Monte Carlo (MCMC) methods is presented. The algorithm consists of two basic steps, one in which an ordinary Metropolis-Hastings up-dating step is used, and another in which an importance sampling scheme is used to calculate the acceptance probability of the Metropolis-Hastings step. In paper number two a method for modelling reports given by actors (or other informants) on their social interaction with others is investigated in a Bayesian framework. The model contains two basic ingredients: the unknown network structure and functions that link this unknown network structure to the reports given by the actors. These functions take the form of probit link functions. An intrinsic problem is that the model is not identified, meaning that there are combinations of values on the unknown structure and the parameters in the probit link functions that are observationally equivalent. Instead of using restrictions for achieving identification, it is proposed that the different observationally equivalent combinations of parameters and unknown structure be investigated a posteriori. Estimation of parameters is carried out using Gibbs sampling with a switching devise that enables transitions between posterior modal regions. The main goal of the procedures is to provide tools for comparisons of different model specifications. Papers 3 and 4, propose Bayesian methods for longitudinal social networks. The premise of the models investigated is that overall change in social networks occurs as a consequence of sequences of incremental changes. Models for the evolution of social networks using continuos-time Markov chains are meant to capture these dynamics. Paper 3 presents an MCMC algorithm for exploring the posteriors of parameters for such Markov chains. More specifically, the unobserved evolution of the network in-between observations is explicitly modelled thereby avoiding the need to deal with explicit formulas for the transition probabilities. This enables likelihood based parameter inference in a wider class of network evolution models than has been available before. Paper 4 builds on the proposed inference procedure of Paper 3 and demonstrates how to perform model selection for a class of network evolution models.

Bayesian statistics in oncology: a guide for the clinical investigator

The rise of evidence-based medicine as well as important progress in statistical methods and computational power have led to a second birth of the >200-year-old Bayesian framework. The use of Bayesian techniques, in particular in the design and interpretation of clinical trials, offers several substantial advantages over the classical statistical approach. First, in contrast to classical statistics, Bayesian analysis allows a direct statement regarding the probability that a treatment was beneficial. Second, Bayesian statistics allow the researcher to incorporate any prior information in the analysis of the experimental results. Third, Bayesian methods can efficiently handle complex statistical models, which are suited for advanced clinical trial designs. Finally, Bayesian statistics encourage a thorough consideration and presentation of the assumptions underlying an analysis, which enables the reader to fully appraise the authors' conclusions. Both Bayesian and classical statistics have their respective strengths and limitations and should be viewed as being complementary to each other; we do not attempt to make a head-to-head comparison, as this is beyond the scope of the present review. Rather, the objective of the present article is to provide a nonmathematical, reader-friendly overview of the current practice of Bayesian statistics coupled with numerous intuitive examples from the field of oncology. It is hoped that this educational review will be a useful resource to the oncologist and result in a better understanding of the scope, strengths, and limitations of the Bayesian approach.

Differential healing response attributed to culprit lesions of patients with acute coronary syndromes and stable coronary artery after implantation of drug-eluting stents: An optical coherence tomography study

BACKGROUND Pathology studies have shown delayed arterial healing in culprit lesions of patients with acute coronary syndrome (ACS) compared with stable coronary artery disease (CAD) after placement of drug-eluting stents (DES). It is unknown whether similar differences exist in-vivo during long-term follow-up. Using optical coherence tomography (OCT), we assessed differences in arterial healing between patients with ACS and stable CAD five years after DES implantation. METHODS AND RESULTS A total of 88 patients comprised of 53 ACS lesions with 7864 struts and 35 stable lesions with 5298 struts were suitable for final OCT analysis five years after DES implantation. The analytical approach was based on a hierarchical Bayesian random-effects model. OCT endpoints were strut coverage, malapposition, protrusion, evaginations and cluster formation. Uncovered (1.7% vs. 0.7%, adjusted p=0.041) or protruding struts (0.50% vs. 0.13%, adjusted p=0.038) were more frequent among ACS compared with stable CAD lesions. A similar trend was observed for malapposed struts (1.33% vs. 0.45%, adj. p=0.072). Clusters of uncovered or malapposed/protruding struts were present in 34.0% of ACS and 14.1% of stable patients (adj. p=0.041). Coronary evaginations were more frequent in patients with ST-elevation myocardial infarction compared with stable CAD patients (0.16 vs. 0.13 per cross section, p=0.027). CONCLUSION Uncovered, malapposed, and protruding stent struts as well as clusters of delayed healing may be more frequent in culprit lesions of ACS compared with stable CAD patients late after DES implantation. Our observational findings suggest a differential healing response attributable to lesion characteristics of patients with ACS compared with stable CAD in-vivo.

A Bayesian approach to estimating the intraclass correlation coefficient

A Bayesian approach to estimating the intraclass correlation coefficient was used for this research project. The background of the intraclass correlation coefficient, a summary of its standard estimators, and a review of basic Bayesian terminology and methodology were presented. The conditional posterior density of the intraclass correlation coefficient was then derived and estimation procedures related to this derivation were shown in detail. Three examples of applications of the conditional posterior density to specific data sets were also included. Two sets of simulation experiments were performed to compare the mean and mode of the conditional posterior density of the intraclass correlation coefficient to more traditional estimators. Non-Bayesian methods of estimation used were: the methods of analysis of variance and maximum likelihood for balanced data; and the methods of MIVQUE (Minimum Variance Quadratic Unbiased Estimation) and maximum likelihood for unbalanced data. The overall conclusion of this research project was that Bayesian estimates of the intraclass correlation coefficient can be appropriate, useful and practical alternatives to traditional methods of estimation. ^

Optimal, minimax, and Bayesian two-stage designs in two-dose phase II clinical trials

Background: For most cytotoxic and biologic anti-cancer agents, the response rate of the drug is commonly assumed to be non-decreasing with an increasing dose. However, an increasing dose does not always result in an appreciable increase in the response rate. This may especially be true at high doses for a biologic agent. Therefore, in a phase II trial the investigators may be interested in testing the anti-tumor activity of a drug at more than one (often two) doses, instead of only at the maximum tolerated dose (MTD). This way, when the lower dose appears equally effective, this dose can be recommended for further confirmatory testing in a phase III trial under potential long-term toxicity and cost considerations. A common approach to designing such a phase II trial has been to use an independent (e.g., Simon's two-stage) design at each dose ignoring the prior knowledge about the ordering of the response probabilities at the different doses. However, failure to account for this ordering constraint in estimating the response probabilities may result in an inefficient design. In this dissertation, we developed extensions of Simon's optimal and minimax two-stage designs, including both frequentist and Bayesian methods, for two doses that assume ordered response rates between doses. ^ Methods: Optimal and minimax two-stage designs are proposed for phase II clinical trials in settings where the true response rates at two dose levels are ordered. We borrow strength between doses using isotonic regression and control the joint and/or marginal error probabilities. Bayesian two-stage designs are also proposed under a stochastic ordering constraint. ^ Results: Compared to Simon's designs, when controlling the power and type I error at the same levels, the proposed frequentist and Bayesian designs reduce the maximum and expected sample sizes. Most of the proposed designs also increase the probability of early termination when the true response rates are poor. ^ Conclusion: Proposed frequentist and Bayesian designs are superior to Simon's designs in terms of operating characteristics (expected sample size and probability of early termination, when the response rates are poor) Thus, the proposed designs lead to more cost-efficient and ethical trials, and may consequently improve and expedite the drug discovery process. The proposed designs may be extended to designs of multiple group trials and drug combination trials.^

Application of Bayesian approach in geotechnical engineering

En esta Tesis Doctoral se emplean y desarrollan Métodos Bayesianos para su aplicación en análisis geotécnicos habituales, con un énfasis particular en (i) la valoración y selección de modelos geotécnicos basados en correlaciones empíricas; en (ii) el desarrollo de predicciones acerca de los resultados esperados en modelos geotécnicos complejos. Se llevan a cabo diferentes aplicaciones a problemas geotécnicos, como es el caso de: (1) En el caso de rocas intactas, se presenta un método Bayesiano para la evaluación de modelos que permiten estimar el módulo de Young a partir de la resistencia a compresión simple (UCS). La metodología desarrollada suministra estimaciones de las incertidumbres de los parámetros y predicciones y es capaz de diferenciar entre las diferentes fuentes de error. Se desarrollan modelos "específicos de roca" para los tipos de roca más comunes y se muestra cómo se pueden "actualizar" esos modelos "iniciales" para incorporar, cuando se encuentra disponible, la nueva información específica del proyecto, reduciendo las incertidumbres del modelo y mejorando sus capacidades predictivas. (2) Para macizos rocosos, se presenta una metodología, fundamentada en un criterio de selección de modelos, que permite determinar el modelo más apropiado, entre un conjunto de candidatos, para estimar el módulo de deformación de un macizo rocoso a partir de un conjunto de datos observados. Una vez que se ha seleccionado el modelo más apropiado, se emplea un método Bayesiano para obtener distribuciones predictivas de los módulos de deformación de macizos rocosos y para actualizarlos con la nueva información específica del proyecto. Este método Bayesiano de actualización puede reducir significativamente la incertidumbre asociada a la predicción, y por lo tanto, afectar las estimaciones que se hagan de la probabilidad de fallo, lo cual es de un interés significativo para los diseños de mecánica de rocas basados en fiabilidad. (3) En las primeras etapas de los diseños de mecánica de rocas, la información acerca de los parámetros geomecánicos y geométricos, las tensiones in-situ o los parámetros de sostenimiento, es, a menudo, escasa o incompleta. Esto plantea dificultades para aplicar las correlaciones empíricas tradicionales que no pueden trabajar con información incompleta para realizar predicciones. Por lo tanto, se propone la utilización de una Red Bayesiana para trabajar con información incompleta y, en particular, se desarrolla un clasificador Naïve Bayes para predecir la probabilidad de ocurrencia de grandes deformaciones (squeezing) en un túnel a partir de cinco parámetros de entrada habitualmente disponibles, al menos parcialmente, en la etapa de diseño. This dissertation employs and develops Bayesian methods to be used in typical geotechnical analyses, with a particular emphasis on (i) the assessment and selection of geotechnical models based on empirical correlations; on (ii) the development of probabilistic predictions of outcomes expected for complex geotechnical models. Examples of application to geotechnical problems are developed, as follows: (1) For intact rocks, we present a Bayesian framework for model assessment to estimate the Young’s moduli based on their UCS. Our approach provides uncertainty estimates of parameters and predictions, and can differentiate among the sources of error. We develop ‘rock-specific’ models for common rock types, and illustrate that such ‘initial’ models can be ‘updated’ to incorporate new project-specific information as it becomes available, reducing model uncertainties and improving their predictive capabilities. (2) For rock masses, we present an approach, based on model selection criteria to select the most appropriate model, among a set of candidate models, to estimate the deformation modulus of a rock mass, given a set of observed data. Once the most appropriate model is selected, a Bayesian framework is employed to develop predictive distributions of the deformation moduli of rock masses, and to update them with new project-specific data. Such Bayesian updating approach can significantly reduce the associated predictive uncertainty, and therefore, affect our computed estimates of probability of failure, which is of significant interest to reliability-based rock engineering design. (3) In the preliminary design stage of rock engineering, the information about geomechanical and geometrical parameters, in situ stress or support parameters is often scarce or incomplete. This poses difficulties in applying traditional empirical correlations that cannot deal with incomplete data to make predictions. Therefore, we propose the use of Bayesian Networks to deal with incomplete data and, in particular, a Naïve Bayes classifier is developed to predict the probability of occurrence of tunnel squeezing based on five input parameters that are commonly available, at least partially, at design stages.

Bayesian models for finding and grouping junctions

In this paper, we propose two Bayesian methods for detecting and grouping junctions. Our junction detection method evolves from the Kona approach, and it is based on a competitive greedy procedure inspired in the region competition method. Then, junction grouping is accomplished by finding connecting paths between pairs of junctions. Path searching is performed by applying a Bayesian A* algorithm that has been recently proposed. Both methods are efficient and robust, and they are tested with synthetic and real images.

Dynamic, convex, and robust optimization with Bayesian learning for response-guided dosing

Thesis (Ph.D.)--University of Washington, 2016-08