Bayesian Analysis

A Decision-Theoretic Comparison of Treatments to Resolve Air Leaks After Lung Surgery Based on Nonparametric Modeling

Yanxun Xu, Peter F. Thall, Peter Müller, and Mehran J. Reza

Full-text: Open access

Abstract

We propose a Bayesian nonparametric utility-based group sequential design for a randomized clinical trial to compare a gel sealant to standard care for resolving air leaks after pulmonary resection. Clinically, resolving air leaks in the days soon after surgery is highly important, since longer resolution time produces undesirable complications that require extended hospitalization. The problem of comparing treatments is complicated by the fact that the resolution time distributions are skewed and multi-modal, so using means is misleading. We address these challenges by assuming Bayesian nonparametric probability models for the resolution time distributions and basing the comparative test on weighted means. The weights are elicited as clinical utilities of the resolution times. The proposed design uses posterior expected utilities as group sequential test criteria. The procedure’s frequentist properties are studied by extensive simulations.

Article information

Source
Bayesian Anal., Volume 12, Number 3 (2017), 639-652.

Dates
First available in Project Euclid: 26 July 2016

Permanent link to this document
https://projecteuclid.org/euclid.ba/1469553354

Digital Object Identifier
doi:10.1214/16-BA1016

Mathematical Reviews number (MathSciNet)
MR3655870

Zentralblatt MATH identifier
1384.62312

Keywords
Bayesian nonparametric clinical trial mesothelioma utility function

Rights
Creative Commons Attribution 4.0 International License.

Citation

Xu, Yanxun; Thall, Peter F.; Müller, Peter; Reza, Mehran J. A Decision-Theoretic Comparison of Treatments to Resolve Air Leaks After Lung Surgery Based on Nonparametric Modeling. Bayesian Anal. 12 (2017), no. 3, 639--652. doi:10.1214/16-BA1016. https://projecteuclid.org/euclid.ba/1469553354


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Supplemental materials

  • Supplementary Material: Supplement: A Decision-Theoretic Comparison of Treatments to Resolve Air Leaks After Lung Surgery Based on Nonparametric Modeling. It includes all the MCMC implementation details, model assessment simulation, more trial simulation results, and sensitivity analyses.