The Impact of Aberrant Data Variability on Drug-Placebo Separation and Drug/Placebo Response in an Acute Schizophrenia Clinical Trial.

Schizophrenia Bulletin Open Pub Date : 2021-08-07 eCollection Date: 2021-01-01 DOI:10.1093/schizbullopen/sgab037
Alan Kott, Stephen Brannan, Xingmei Wang, David Daniel
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引用次数: 2

Abstract

Objective: In the current posthoc analyses, we evaluated the impact of markers of aberrant data variability on drug placebo separation and placebo and drug response in an acute schizophrenia clinical trial.

Methods: Positive and negative syndrome scale data were obtained from a phase 2, randomized, double-blind, placebo controlled trial in hospitalized adults with schizophrenia experiencing an acute exacerbation. We assessed the impact of a total of six markers of aberrant data variability: erratic ratings, unusually large postbaseline improvement, high and low mean square successive difference (MSSD), identical and nearly identical ratings and compared the drug placebo difference, drug and treatment response at last visit in affected subjects vs those not affected. All analyses were conducted using generalized linear models.

Results: In this posthoc analysis, drug placebo separation decreased with the presence of most markers of aberrant data variability. The only exception was high MSSD was associated with significant increase in the signal. In the affected subjects, the presence of indicators of increased data variability augmented the response to placebo, in the case of large postbaseline change and high MSSD, significantly. The presence of indicators of decreased variability numerically but not statistically decreased the response to placebo. Similar findings were observed in the drug treatment group with the exception of erratic ratings that numerically but not statistically decreased the response to the drug.

Discussion: The presence of most indicators of aberrant data variability had a detrimental effect on drug-placebo separation and showed different effects on placebo and treatment response.

Abstract Image

Abstract Image

急性精神分裂症临床试验中异常数据变异性对药物-安慰剂分离和药物/安慰剂反应的影响
目的:在当前的事后分析中,我们评估了一项急性精神分裂症临床试验中异常数据变异性标志物对药物安慰剂分离以及安慰剂和药物反应的影响。方法:阳性和阴性综合征量表数据来自一项2期、随机、双盲、安慰剂对照试验,该试验中住院的成年精神分裂症患者急性加重。我们评估了总共六种异常数据变异性标记的影响:不稳定的评分、基线后异常大的改善、高均方连续差和低均方连续差(MSSD)、相同和几乎相同的评分,并比较了药物安慰剂的差异、受影响受试者与未受影响受试者最后一次就诊时的药物和治疗反应。所有分析均采用广义线性模型进行。结果:在这个事后分析中,药物安慰剂分离随着大多数异常数据变异性标记的存在而减少。唯一的例外是高MSSD与信号的显著增加有关。在受影响的受试者中,在基线后变化大且MSSD高的情况下,数据变异性增加的指标的存在显著增强了对安慰剂的反应。降低可变性指标的存在在数字上而不是统计上降低了对安慰剂的反应。在药物治疗组中也观察到类似的结果,但不稳定的评分在数字上而不是统计上降低了对药物的反应。讨论:大多数异常数据变异性指标的存在对药物-安慰剂分离产生不利影响,对安慰剂和治疗反应的影响不同。
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