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This IMA Volume in Mathematics and its Applications STATISTICAL MODELS IN EPIDEMIOLOGY, THE ENVIRONMENT,AND CLINICAL TRIALS is a combined proceedings on "Design and Analysis of Clinical Trials" and "Statistics and Epidemiology: Environment and Health. " This volume is the third series based on the proceedings of a very successful 1997 IMA Summer Program on "Statistics in the Health Sciences. " I would like to thank the organizers: M. Elizabeth Halloran of Emory University (Biostatistics) and Donald A. Berry of Duke University (Insti tute of Statistics and Decision Sciences and Cancer Center Biostatistics) for their excellent work as organizers of the meeting and for editing the proceedings. I am grateful to Seymour Geisser of University of Minnesota (Statistics), Patricia Grambsch, University of Minnesota (Biostatistics); Joel Greenhouse, Carnegie Mellon University (Statistics); Nicholas Lange, Harvard Medical School (Brain Imaging Center, McLean Hospital); Barry Margolin, University of North Carolina-Chapel Hill (Biostatistics); Sandy Weisberg, University of Minnesota (Statistics); Scott Zeger, Johns Hop kins University (Biostatistics); and Marvin Zelen, Harvard School of Public Health (Biostatistics) for organizing the six weeks summer program. I also take this opportunity to thank the National Science Foundation (NSF) and the Army Research Office (ARO), whose financial support made the workshop possible. Willard Miller, Jr.
This IMA Volume in Mathematics and its Applications STATISTICAL MODELS IN EPIDEMIOLOGY, THE ENVIRONMENT,AND CLINICAL TRIALS is a combined proceedings on "Design and Analysis of Clinical Trials" and "Statistics and Epidemiology: Environment and Health. " This volume is the third series based on the proceedings of a very successful 1997 IMA Summer Program on "Statistics in the Health Sciences. " I would like to thank the organizers: M. Elizabeth Halloran of Emory University (Biostatistics) and Donald A. Berry of Duke University (Insti tute of Statistics and Decision Sciences and Cancer Center Biostatistics) for their excellent work as organizers of the meeting and for editing the proceedings. I am grateful to Seymour Geisser of University of Minnesota (Statistics), Patricia Grambsch, University of Minnesota (Biostatistics); Joel Greenhouse, Carnegie Mellon University (Statistics); Nicholas Lange, Harvard Medical School (Brain Imaging Center, McLean Hospital); Barry Margolin, University of North Carolina-Chapel Hill (Biostatistics); Sandy Weisberg, University of Minnesota (Statistics); Scott Zeger, Johns Hop kins University (Biostatistics); and Marvin Zelen, Harvard School of Public Health (Biostatistics) for organizing the six weeks summer program. I also take this opportunity to thank the National Science Foundation (NSF) and the Army Research Office (ARO), whose financial support made the workshop possible. Willard Miller, Jr.
This self-contained account of the statistical basis of epidemiology has been written for those with a basic training in biology. It is specifically intended for students enrolled for a masters degree in epidemiology, clinical epidemiology, or biostatistics.
Probability, Statistics and Modelling in Public Health consists of refereed contributions by expert biostatisticians that discuss various probabilistic and statistical models used in public health. Many of them are based on the work of Marvin Zelen of the Harvard School of Public Health. Topics discussed include models based on Markov and semi-Markov processes, multi-state models, models and methods in lifetime data analysis, accelerated failure models, design and analysis of clinical trials, Bayesian methods, pharmaceutical and environmental statistics, degradation models, epidemiological methods, screening programs, early detection of diseases, and measurement and analysis of quality of life.
Clinical trials are used to elucidate the most appropriate preventive, diagnostic, or treatment options for individuals with a given medical condition. Perhaps the most essential feature of a clinical trial is that it aims to use results based on a limited sample of research participants to see if the intervention is safe and effective or if it is comparable to a comparison treatment. Sample size is a crucial component of any clinical trial. A trial with a small number of research participants is more prone to variability and carries a considerable risk of failing to demonstrate the effectiveness of a given intervention when one really is present. This may occur in phase I (safety and pharmacologic profiles), II (pilot efficacy evaluation), and III (extensive assessment of safety and efficacy) trials. Although phase I and II studies may have smaller sample sizes, they usually have adequate statistical power, which is the committee's definition of a "large" trial. Sometimes a trial with eight participants may have adequate statistical power, statistical power being the probability of rejecting the null hypothesis when the hypothesis is false. Small Clinical Trials assesses the current methodologies and the appropriate situations for the conduct of clinical trials with small sample sizes. This report assesses the published literature on various strategies such as (1) meta-analysis to combine disparate information from several studies including Bayesian techniques as in the confidence profile method and (2) other alternatives such as assessing therapeutic results in a single treated population (e.g., astronauts) by sequentially measuring whether the intervention is falling above or below a preestablished probability outcome range and meeting predesigned specifications as opposed to incremental improvement.
This User’s Guide is a resource for investigators and stakeholders who develop and review observational comparative effectiveness research protocols. It explains how to (1) identify key considerations and best practices for research design; (2) build a protocol based on these standards and best practices; and (3) judge the adequacy and completeness of a protocol. Eleven chapters cover all aspects of research design, including: developing study objectives, defining and refining study questions, addressing the heterogeneity of treatment effect, characterizing exposure, selecting a comparator, defining and measuring outcomes, and identifying optimal data sources. Checklists of guidance and key considerations for protocols are provided at the end of each chapter. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews. More more information, please consult the Agency website: www.effectivehealthcare.ahrq.gov)
Data sharing can accelerate new discoveries by avoiding duplicative trials, stimulating new ideas for research, and enabling the maximal scientific knowledge and benefits to be gained from the efforts of clinical trial participants and investigators. At the same time, sharing clinical trial data presents risks, burdens, and challenges. These include the need to protect the privacy and honor the consent of clinical trial participants; safeguard the legitimate economic interests of sponsors; and guard against invalid secondary analyses, which could undermine trust in clinical trials or otherwise harm public health. Sharing Clinical Trial Data presents activities and strategies for the responsible sharing of clinical trial data. With the goal of increasing scientific knowledge to lead to better therapies for patients, this book identifies guiding principles and makes recommendations to maximize the benefits and minimize risks. This report offers guidance on the types of clinical trial data available at different points in the process, the points in the process at which each type of data should be shared, methods for sharing data, what groups should have access to data, and future knowledge and infrastructure needs. Responsible sharing of clinical trial data will allow other investigators to replicate published findings and carry out additional analyses, strengthen the evidence base for regulatory and clinical decisions, and increase the scientific knowledge gained from investments by the funders of clinical trials. The recommendations of Sharing Clinical Trial Data will be useful both now and well into the future as improved sharing of data leads to a stronger evidence base for treatment. This book will be of interest to stakeholders across the spectrum of research-from funders, to researchers, to journals, to physicians, and ultimately, to patients.
In the late 1980s, the National Cancer Institute initiated an investigation of cancer risks in populations near 52 commercial nuclear power plants and 10 Department of Energy nuclear facilities (including research and nuclear weapons production facilities and one reprocessing plant) in the United States. The results of the NCI investigation were used a primary resource for communicating with the public about the cancer risks near the nuclear facilities. However, this study is now over 20 years old. The U.S. Nuclear Regulatory Commission requested that the National Academy of Sciences provide an updated assessment of cancer risks in populations near USNRC-licensed nuclear facilities that utilize or process uranium for the production of electricity. Analysis of Cancer Risks in Populations near Nuclear Facilities: Phase 1 focuses on identifying scientifically sound approaches for carrying out an assessment of cancer risks associated with living near a nuclear facility, judgments about the strengths and weaknesses of various statistical power, ability to assess potential confounding factors, possible biases, and required effort. The results from this Phase 1 study will be used to inform the design of cancer risk assessment, which will be carried out in Phase 2. This report is beneficial for the general public, communities near nuclear facilities, stakeholders, healthcare providers, policy makers, state and local officials, community leaders, and the media.
Bayesian methods combine the evidence from the data at hand with previous quantitative knowledge to analyse practical problems in a wide range of areas. The calculations were previously complex, but it is now possible to routinely apply Bayesian methods due to advances in computing technology and the use of new sampling methods for estimating parameters. Such developments together with the availability of freeware such as WINBUGS and R have facilitated a rapid growth in the use of Bayesian methods, allowing their application in many scientific disciplines, including applied statistics, public health research, medical science, the social sciences and economics. Following the success of the first edition, this reworked and updated book provides an accessible approach to Bayesian computing and analysis, with an emphasis on the principles of prior selection, identification and the interpretation of real data sets. The second edition: Provides an integrated presentation of theory, examples, applications and computer algorithms. Discusses the role of Markov Chain Monte Carlo methods in computing and estimation. Includes a wide range of interdisciplinary applications, and a large selection of worked examples from the health and social sciences. Features a comprehensive range of methodologies and modelling techniques, and examines model fitting in practice using Bayesian principles. Provides exercises designed to help reinforce the reader’s knowledge and a supplementary website containing data sets and relevant programs. Bayesian Statistical Modelling is ideal for researchers in applied statistics, medical science, public health and the social sciences, who will benefit greatly from the examples and applications featured. The book will also appeal to graduate students of applied statistics, data analysis and Bayesian methods, and will provide a great source of reference for both researchers and students. Praise for the First Edition: “It is a remarkable achievement to have carried out such a range of analysis on such a range of data sets. I found this book comprehensive and stimulating, and was thoroughly impressed with both the depth and the range of the discussions it contains.” – ISI - Short Book Reviews “This is an excellent introductory book on Bayesian modelling techniques and data analysis” – Biometrics “The book fills an important niche in the statistical literature and should be a very valuable resource for students and professionals who are utilizing Bayesian methods.” – Journal of Mathematical Psychology