Including historical data in the analysis of clinical trials using the modified power priors: theoretical overview and sampling algorithms

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Including historical data in the analysis of clinical trials using the modified power priors: theoretical overview and sampling algorithms Joost van Rosmalen 1, David Dejardin 2,3, and Emmanuel Lesaffre 1,2 1 Department of Biostatistics, Erasmus MC, Rotterdam, the Netherlands 2 I-BioStat, KU Leuven, Leuven, Belgium 3 Biometrics, Roche Pharmaceutical Research and Early Development, Basel, Switzerland Bayes Pharma meeting 2014 Bayes Pharma meeting 2014 1 / 25

Contents Introduction Theoretical overview Sampling algorithms Behaviour of modified power prior Discussion Bayes Pharma meeting 2014 2 / 25

Introduction Including historical data in analysis of clinical studies is a tantalizing prospect. Advantages: improved precision and statistical power, fewer patients needed in new study. Common example: RCTs in which control group receives same treatment as in previous studies. Including historical data in analysis is controversial. Bayes Pharma meeting 2014 3 / 25

Introduction Hypothetical example: probability of success of new surgical technique Current study: 50 successes out of 100 cases Previous study: 50 successes out of 100 cases Binomial model, uniform prior for probability Bayes Pharma meeting 2014 4 / 25

Introduction Current data: k= 50 n= 100, historical data: k= 50 n= 100 Posterior density of p 0 5 10 15 New study only Pooled data 0.3 0.4 0.5 0.6 0.7 p (probability of success) Bayes Pharma meeting 2014 5 / 25

Introduction Alternative to pooling: include historical data in the analysis, but assign lower weight to historical data. Ibrahim & Chen (Stat. Science, 2000) proposed power prior: π CPP (β H, θ) L H (β) θ p(β), with p(β) the prior density of model parameters, H the historical data, and θ (with 0 θ 1) the relative weight of the historical data. Referred to as conditional power prior (CPP) Combining with likelihood of new data set D yields posterior: p CPP (β D, H, θ) L D (β)l H (β) θ p(β). Bayes Pharma meeting 2014 6 / 25

Theoretical overview Chen & Ibrahim (Bayesian Analysis, 2006): specific choices of θ in CPP equivalent to meta-analysis. Gaussian model for current (y D 1,... y D n D ) and hist. data (y H 1,... y H n H ) y D 1,... y D n N(µ D, σ 2 D ) and y H 1,... y H n H N(µ H, σ 2 H ) µ D N(µ, τ 2 ) and µ H N(µ, τ 2 ) p(µ) 1 Result: distribution of µ H given y1 D,... y n D and y1 H,... y n H H equal to CPP with: 1 θ = 2τ 2 n H /σh 2 + 1 Results can be extended to linear regression, GLMs. Bayes Pharma meeting 2014 7 / 25

Theoretical overview Alternative approach: estimate θ using observed data. Result: adaptive pooling of historical and current data. Original power prior (Ibrahim & Chen, 2000): π OPP (β, θ D, H) L H (β) θ p(β)p(θ), with p(θ) prior distribution of weight parameter. Bayes Pharma meeting 2014 8 / 25

Theoretical overview Duan et al. (Environmetrics, 2006): π OPP (β, θ D, H) does not satisfy likelihood principle. Multiplying L H (β) by arbitrary constant k yields π OPP (β, θ D, H) k θ L H (β) θ p(β)p(θ), thus changing posterior distribution of θ. Original power prior gives low values of θ in large data sets, even if L D (β) = L H (β). Bayes Pharma meeting 2014 9 / 25

Theoretical overview Duan et al. (2006) proposed modified power prior (MPP): π MPP (β, θ H) C(θ)L H (β) θ p(β)p(θ), with C(θ) = 1 LH (β) θ p(β) dβ. Bayes Pharma meeting 2014 10 / 25

Theoretical overview Posterior density of θ 0 2 4 6 8 10 Modified power prior Original power prior 0.0 0.2 0.4 0.6 0.8 1.0 θ (weight of historical data) Bayes Pharma meeting 2014 11 / 25

Theoretical overview Current data: k= 50 n= 100, historical data: k= 50 n= 100 Posterior density of p 0 5 10 15 New study only Pooled data Modified power prior 0.3 0.4 0.5 0.6 0.7 p (probability of success) Bayes Pharma meeting 2014 12 / 25

Sampling algorithms Using MPP, prior involves integral L H (β) θ p(β) dβ in C(θ). In MCMC sampler, C(θ) must be available in every iteration: large computation time not acceptable. Possible approaches for simple models: Analytical integration Numerical integration MPP has only been applied in models with closed-form posterior. New algorithms for complex models: Laplace approximation (talk of David) Path sampling Bayes Pharma meeting 2014 13 / 25

Sampling algorithms: path sampling Friel and Pettitt (JRSS-B, 2008): calculation of marginal likelihood using power posteriors. Weight parameter used as auxiliary variable for calculating marginal likelihood (i.e. L H (β) θ p(β) dβ with θ = 1). Idea of algorithm: logarithm of C(θ) equals integrated log-likelihood: ( log ) θ L H (β) θ p(β) dθ = E LH (β) θ p(β) [log(l H(β))] dθ, θ =0 with β distributed as L H (β) θ p(β). Bayes Pharma meeting 2014 14 / 25

Sampling algorithms: path sampling Path sampling algorithm: Choose θ (step size for θ) and n iter (iterations per step). Set θ = 0. Repeat until θ = 1: 1 Increase θ by θ. 2 Sample n iter MCMC iterations from L H (β) θ p(β). 3 Calculate log(l H (β)) as the average of log(l H (β)) using βs sampled for the current value of θ Calculate cumulative sum of log(l H (β)), as a function of θ. LH (β) θ p(β) dβ is proportional to exponential of the cumulative sum. Bayes Pharma meeting 2014 15 / 25

C(θ) calculated for finite number of points in [0, 1] For intermediate values: use linear interpolation of log(c(θ)) Few or no burn-in iterations required per value of θ. Numerical comparisons show that path sampling algorithm is accurate. For posterior results of MPP: use MCMC sampler and look up value of C(θ) in every iteration. Bayes Pharma meeting 2014 16 / 25

Behaviour of modified power prior If L H (β) = L D (β) and p(θ) = 1, posterior mode of θ is 1. But posterior CI of θ often very wide. Illustration with Gaussian model using results of Duan et al. (2006). Bayes Pharma meeting 2014 17 / 25

Behaviour of modified power prior Gaussian model: historical and current data N(µ, σ 2 ) Beta(1,1) prior (i.e. uniform) for θ Jeffreys prior for µ and σ 2, π(µ, σ 2 ) = (1/σ 2 ) 3/2 n = 100, x = 0, s 2 = 1 for current data Three settings for historical data: 1 n 0 = 100, x H = 0, s0 2 = 1 2 n 0 = 100, x H = 0.5, s0 2 = 1 3 n 0 = 100, x H [ 4, 4], s0 2 = 1 Bayes Pharma meeting 2014 18 / 25

Behaviour of modified power prior Figure: Posterior distribution of θ with equal historical and current data Posterior density of θ 0.0 0.5 1.0 1.5 2.0 0.0 0.2 0.4 0.6 0.8 1.0 θ (weight of historical data) Bayes Pharma meeting 2014 19 / 25

Behaviour of modified power prior Figure: Posterior distribution of θ with x = 0 and x H = 0.5 Posterior density of θ 0.0 0.5 1.0 1.5 2.0 2.5 3.0 0.0 0.2 0.4 0.6 0.8 1.0 θ (weight of historical data) Bayes Pharma meeting 2014 20 / 25

Behaviour of modified power prior Figure: Posterior mean of θ as a function of x H Posterior mean of θ (weight of historical data) 0.0 0.2 0.4 0.6 0.8 1.0 4 2 0 2 4 Sample average of historical data Bayes Pharma meeting 2014 21 / 25

Behaviour of modified power prior Figure: Posterior mean of µ as a function of x H Posterior mean of µ 0.2 0.1 0.0 0.1 0.2 4 2 0 2 4 Sample average of historical data Bayes Pharma meeting 2014 22 / 25

Behaviour of modified power prior Largest effect of historical data when x = 0 and x H 0.41, corresponding with significant difference in frequentist analysis (p-value two-sample t-test: 0.005). In Gaussian model, posterior mean of θ never becomes 1 using flat prior for θ. Scaling constant β L H(β) θ p(β) dβ is not finite with reference prior f (µ, σ 2 ) = 1 σ 2 (Duan et al. 2006) Bayes Pharma meeting 2014 23 / 25

Discussion Modified power prior is an interesting and versatile method. Advantages: Applicable to any parametric Bayesian model Normality assumption for parameters not needed. Adaptive pooling happens automatically. Limitations: Any discrepancy between historical and current data leads to downweighting. Amount of discounting often considered too severe (Neelon & O Malley, J Biomet Biostat 2010). Unclear how prior of θ must be chosen. Implementation requires more work than standard Bayesian analysis. Bayes Pharma meeting 2014 24 / 25

Discussion Topics for future research: Definition of modified power prior with multiple historical data sets. Comparison of MPP with other methods, e.g. meta-analysis. What to do if β L H(β) θ p(β) dβ is not finite for all θ (0, 1) Frequentist characteristics Theoretical understanding of MPP needs to be improved. Bayes Pharma meeting 2014 25 / 25