eprintid: 10046121 rev_number: 20 eprint_status: archive userid: 608 dir: disk0/10/04/61/21 datestamp: 2018-04-05 11:50:38 lastmod: 2021-12-13 23:48:22 status_changed: 2018-04-05 11:50:38 type: article metadata_visibility: show creators_name: Royston, P title: Power and sample-size analysis for the Royston–Parmar combined test in clinical trials with a time-to-event outcome ispublished: pub divisions: UCL divisions: B02 divisions: D65 divisions: J38 keywords: power_ct, randomized controlled trial, time-to-event outcome, restricted mean survival time, log-rank test, Cox test, combined test, treatment effect, hypothesis testing, flexible parametric model note: This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions. abstract: Randomized controlled trials with a time-to-event outcome are usually designed and analyzed assuming proportional hazards (PH) of the treatment effect. The sample-size calculation is based on a log-rank test or the nearly identical Cox test, henceforth called the Cox/log-rank test. Nonproportional hazards (non-PH) has become more common in trials and is recognized as a potential threat to interpreting the trial treatment effect and the power of the log-rank test—hence to the success of the trial. To address the issue, in 2016, Royston and Parmar (BMC Medical Research Methodology 16: 16) proposed a "combined test" of the global null hypothesis of identical survival curves in each trial arm. The Cox/logrank test is combined with a new test derived from the maximal standardized difference in restricted mean survival time (RMST) between the trial arms. The test statistic is based on evaluations of the between-arm difference in RMST over several preselected time points. The combined test involves the minimum p-value across the Cox/log-rank and RMST-based tests, appropriately standardized to have the correct distribution under the global null hypothesis. In this article, I introduce a new command, power_ct, that uses simulation to implement power and sample-size calculations for the combined test. power_ct supports designs with PH or non-PH of the treatment effect. I provide examples in which the power of the combined test is compared with that of the Cox/log-rank test under PH and non-PH scenarios. I conclude by offering guidance for sample-size calculations in time-to-event trials to allow for possible non-PH. date: 2018 date_type: published publisher: StataCorp official_url: https://www.stata-journal.com/sj18-1.html oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1546994 lyricists_name: Royston, John lyricists_id: JPROY48 actors_name: Royston, John actors_name: Allington-Smith, Dominic actors_id: JPROY48 actors_id: DAALL44 actors_role: owner actors_role: impersonator full_text_status: public publication: Stata Journal volume: 18 number: 1 pagerange: 3-21 issn: 1536-867X citation: Royston, P; (2018) Power and sample-size analysis for the Royston–Parmar combined test in clinical trials with a time-to-event outcome. Stata Journal , 18 (1) pp. 3-21. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10046121/1/Royston_sjart_st0510.pdf