Prevalence Estimation
Unlike the incidence rate comparison, all SEARCH Cohort Study participants can be
used for the prevalence rate analyses since the incident rate calculations need to remove
participants who have the outcome present at visit 1 from the analyses. With this in mind
we estimate that there will be 3166 participants available to contribute to prevalence rate
estimates. Based on this, Table 6-3 shows a variety of scenarios for detectable
differences comparing groups (i.e., type 1 vs type 2, non-Hispanic white vs others, etc)
using a chi-square test to compare groups with alpha=0.05 (2-sided).
Table 6-3: Scenarios for Detecting Statistical Differences in Prevalence of Retinopathy and
Neuropathy
Outcome 316/2849
473/2692
2112/1049
(Anticipated
NHW
vs. Other Race Split)
Percentage with trait in smaller group
10%
20%
10%
20%
10%
20%
Detectable Difference (Power)
Retinopathy
.16 (81)
.28 (86)
.15 (82)
.27 (89)
.14 (89)
.25 (88)
5%
15%
5%
15%
5%
15%
Neuropathy
.10 (85)
.22 (83)
.09 (84)
.21 (85)
.08 (88)
.20 (93)
Section 6B - Statistical Considerations (Phase 3 - 12/2010)
Section 6B - Page 6
Cohort
Study
2
2
2
2
1
/ 2
1
1
(1
)(
) (
)
r
Z
Z
k
n
α
β
σ
σ
−
−
−
+
+
Δ =
Based on this table, we see that there is 81% power to detect a difference between Type 1
and Type 2 participants on their prevalence of retinopathy: 10% in the Type 1 group and
16% or higher in the Type 2 group, a realistic potential comparison given early pilot
findings of 18% of youth with evidence of DR among the first 38 evaluated.
6.2.3.
Longitudinal Models Component
For the purposes of estimating the sample size needed to detect a significant difference
with sufficient power, calculations were based on comparing measurements after
adjusting for visit 1 data. These calculations need to account for the proportion of the
variance in the outcome that is explained by the visit 1 values.
Although our full
longitudinal models
will incorporate all
intermediate time points
into the final analysis, our power
calculation is based on examining the difference in the outcome of interest adjusting only
for the visit 1 assessment of the outcome. Therefore, these power calculations will be
conservative, since the additional information provided by the intermediate assessments
of outcome measures are not included.
The following formula was used to describe the minimum detectable difference in terms
of standard deviations between the participants in groups (i.e., Type 1 versus Type 2). In
the formula, r2 is the percent of the variance of the follow-up outcome explained by the
visit 1 measurements, Z
1-α/2
is the value from the standard normal distribution
corresponding to the alpha level chosen (1.96, which corresponds to alpha=0.05 [two
sided]), Z
1-β
corresponds to the power chosen for the study (80%), σ
2
is the variance of the
outcome of interest (i.e. systolic blood pressure), n
1
is the number of participants in the
Type 1, k is the ratio of n
1
/n
2
(sample size in type 1 and type 2 groups, respectively) and
Δ corresponds to the detectable difference in the mean values of the two groups being
compared. Using this formula, we examined the detectable differences for several
possible r
2
values assuming 80% power and alpha=0.05. From SEARCH 1 and 2,
standard deviations for systolic blood pressure, BMI - Z-scores and LDL cholesterol were
estimated as 12.7, .85 and 29, respectively. Using these numbers, Table 6-4 describes the
detectable differences if there were 450 participants in the Type 2 group and 2711 in the
Type 1 group.
Section 6B - Statistical Considerations (Phase 3 - 12/2010)
Section 6B - Page 7
Cohort
Study
Table 6-4: Detectable Differences in Systolic Blood Pressure, BMI Z-Score and
LDL-Cholesterol Given 450 Type 2 Participants 2711 Type 1 Participants
Detectable Differences
with 80% Power
Correlation Between Baseline and Follow-Up Measures
Sample Size (n
1
/n
2
)
(2711/450)
.50 .65 .75
.86
Systolic Blood Pressure
1.57 mmHg
1.38 mmHg
1.20 mmHg
0.95 mmHg
BMI (Z-Score)
.11 (SD)
.09 (SD)
.08 (SD)
.06 (SD)
LDL-Cholesterol
3.58 mg/dl
3.14 mg/dl
2.73 mg/dl
2.18 mg/dl
As can be seen, if the correlation between the baseline and follow-up measurements is
moderate (.50) then we have 80% power to detect a difference of 1.51 mmHg for the
Type 1 versus Type 2 comparison of blood pressure change. As stated above, these
estimates should be conservative because when the additional yearly measurements are
incorporated into the longitudinal analyses, there will be additional precision which
should reduce variability and allow for smaller between group differences to be detected.
Section 6B - Statistical Considerations (Phase 3 - 12/2010)
Section 6B - Page 8
Cohort
Study
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SEARCH Phase 3 Protocol - Section 7
Data Management
Table of Contents
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