For a one-sided Wald test use the signed normal Wald statistic, rather than its square. The maximum-likelihood estimate is the sample mean , with exact variance , so
A sum of independent normal random variables is normal, giving and hence . Under the null hypothesis its mean is zero:
Thus its null distribution is exactly the standard normal distribution, without an asymptotic approximation. If the squared Wald statistic convention is used, has a chi-squared distribution with one degree of freedom; the signed form is needed to distinguish the two directions.
The same affine transformation of the normal distribution gives
Its variance stays one while its mean moves positively. This is the exact alternative distribution used to calculate statistical power. The square, if used instead, has a noncentral chi-squared distribution with one degree of freedom and noncentrality .
Let denote a quantile of the standard normal distribution. Reject when . The statistical power at the specified positive effect is
Equating this to and using gives . Thus, for the usual target ,
Rounding up ensures at least the target statistical power. This normal-mean sample size calculation assumes a positive integer sample size; if a requested power is at most , every positive sample size already exceeds that target for , and one should not square a negative quantile sum to impose an unnecessary lower bound.
Write , , and let be independent standard normal random variables obtained by centering and scaling the separate stage means. Then
The second statistic uses all patients, so the statistics are correlated even though the stages' new observations are independent. Their covariance is and each variance is one. This gives the exact bivariate normal distribution
Under the null hypothesis both means are zero. At replace by ; the mean vector is . In this group sequential design the full-sample statistic may be viewed as a potential statistic from the underlying sequence of outcomes, even on paths where recruitment stops.
Set . Under the null hypothesis rejection requires both and . Since has the standard normal distribution,
The bivariate normal distribution in the preceding calculation has a nonsingular covariance matrix and strictly positive statistical probability density everywhere. For every finite futility boundary and , the open rectangle has positive probability. Therefore
For an explicit expression, conditional on the full-sample statistic is under the null hypothesis, yielding
The Type I error is reduced because some otherwise rejecting paths stop for futility. Equality is approached as , but does not hold at a finite futility boundary.
Let and denote the first- and second-stage sample means, let , and write . Continuation is the selection event . The second-stage sample mean stays independent of , so . The first-stage sample mean has a truncated normal distribution. With and the upper-tail Inverse Mills ratio ,
The positive conditional selection bias after futility continuation comes from selecting unusually large first-stage outcomes. The unconditional sample mean of a fixed observations would be unbiased; that is a different sampling distribution from the one restricted to continued trials.
As , , and , so the estimator bias tends to zero. It decreases with : differentiating gives , because for a standard normal random variable. Thus
Use a Rao-Blackwell estimator after interim selection, which is exactly conditionally unbiased. The second-stage sample mean alone is unbiased conditional on continuation, but discards the earlier observations. Apply the Rao-Blackwell theorem by averaging conditional on the combined sample mean and the fact of continuation.
Set and . Before truncation, is , a distribution whose mean no longer involves the unknown . After imposing , its mean is . Since , the resulting estimator is
It uses the outcomes from both stages through their combined sample mean. By iterated expectation, , so its conditional estimator bias is zero, compared with the strictly positive estimator bias above. Its conditional variance is no larger than that of the second-stage-only estimate. This does not assert a smaller mean squared error than every biased estimator.

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