Journal
STATISTICS IN MEDICINE
Volume 39, Issue 24, Pages 3427-3457Publisher
WILEY
DOI: 10.1002/sim.8674
Keywords
Exact power; inverse variance weight; Mantel-Haenszel weight; noninferiority trial; rare events; skewness correction
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In a series of articles, Gart and Nam construct the efficient score tests and confidence intervals with or without skewness correction for stratified comparisons of binomial proportions on the risk difference, relative risk, and odds ratio effect metrics. However, the stratified score methods and their properties are not well understood. We rederive the efficient score tests, which reveals their theoretical relationship with the contrast-based score tests, and provides a basis for adapting the method by using other weighting schemes. The inverse variance weight is optimal for a common treatment effect in large samples. We explore the behavior of the score approach in the presence of extreme outcomes when either no or all subjects in some strata are responders, and provide guidance on the choice of weights in the analysis of rare events. The score method is recommended for studies with a small number of moderate or large sized strata. A general framework is proposed to calculate the asymptotic power and sample size for the score test in superiority, noninferiority and equivalence clinical trials, or case-control studies. We also describe a nearly exact procedure that underestimates the exact power, but the degree of underestimation can be controlled to a negligible level. The proposed methods are illustrated by numerical examples.
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