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Original Articles

Bayesian Hierarchical Modeling for Detecting Safety Signals in Clinical Trials

, &
Pages 1006-1029
Received 05 Jan 2010
Accepted 27 Aug 2010
Published online: 10 Aug 2011

Detection of safety signals from clinical trial adverse event data is critical in drug development, but carries a challenging statistical multiplicity problem. Bayesian hierarchical mixture modeling is appealing for its ability to borrow strength across subgroups in the data, as well as moderate extreme findings most likely due merely to chance. We implement such a model for subject incidence (Berry and Berry, 2004 Berry , S. , Berry , D. ( 2004 ). Accounting for multiplicities in assessing drug safety: A three-level hierarchical mixture model . Biometrics 60 : 418426 .[Crossref], [PubMed], [Web of Science ®] [Google Scholar]) using a binomial likelihood, and extend it to subject-year adjusted incidence rate estimation under a Poisson likelihood. We use simulation to choose a signal detection threshold, and illustrate some effective graphics for displaying the flagged signals.

ACKNOWLEDGMENTS

We are grateful to Dr. George Rochester for helpful discussions, and to Drs. Steven Snapinn and George Williams for constructive comments and suggestions. We also thank two referees for their critical reading of this material and for their insightful comments that greatly improved the paper.

 

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