Methodological approaches for analysing data from therapeutic efficacy studies

Malaria Journal

Leonardo K. Basco¹  Solange Whegang Youdom² 

[1] Aix-Marseille Université, Institut de Recherche pour le Développement (IRD), Assistance Publique – Hôpitaux de Marseille (AP-HM), Service de Santé des Armées (SSA), Unité Mixte de Recherche Vecteurs—Infections Tropicales et Méditerranéennes (VITROME), Marseille, France;Institut Hospitalo-Universitaire (IHU)—Méditerranée Infection, Marseille, France;Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, P.O. Box 96, Dschang, Cameroon;

关键词: Plasmodium falciparum;    Drug resistance;    Artemisinin;    Ordinal outcome;    Multiple comparison;    Network meta-analysis;    Ranking;    Analytics;    Data science;   

DOI  :  10.1186/s12936-021-03768-1

来源: Springer

【 摘 要 】

Several anti-malarial drugs have been evaluated in randomized clinical trials to treat acute uncomplicated Plasmodium falciparum malaria. The outcome of anti-malarial drug efficacy studies is classified into one of four possible outcomes defined by the World Health Organization: adequate clinical and parasitological response, late parasitological failure, late clinical failure, early treatment failure. These four ordered categories are ordinal data, which are reduced to either a binary outcome (i.e., treatment success and treatment failure) to calculate the proportions of treatment failure or to time-to-event outcome for Kaplan–Meier survival analysis. The arbitrary transition from 4-level ordered categories to 2-level type categories results in a loss of statistical power. In the opinion of the authors, this outcome can be considered as ordinal at a fixed endpoint or at longitudinal endpoints. Alternative statistical methods can be applied to 4-level ordinal categories of therapeutic response to optimize data exploitation. Furthermore, network meta-analysis is useful not only for direct comparison of drugs which were evaluated together in a randomized design, but also for indirect comparison of different artemisinin-based combinations across different clinical studies using a common drug comparator, with the aim to determine the ranking order of drug efficacy. Previous works conducted in Cameroonian children served as data source to illustrate the feasibility of these novel statistical approaches. Data analysis based on ordinal end-point may be helpful to gain further insight into anti-malarial drug efficacy.

【 授权许可】

CC BY