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Table 1 Simulation plan according to ADEMP guidelines

From: Impact of limited sample size and follow-up on single event survival extrapolation for health technology assessment: a simulation study

Category

Description

Aims

The aim of this study was to assess the performance of standard parametric survival analysis techniques for analysis of time-to-event data from clinical trials under conditions of limited data due to small samples or short follow-up.

Data generating mechanism

Data were generated for the event of interest from an exponential survival distribution, characterized by a constant hazard rate, λ.

Estimands and population targets

- Exponential distribution of event times

- Median survival time, t where S(t) = 0.5

- One-year landmark survival probability, S(t) where t = 365 days

- Population time horizon, THpop, defined at 1% survival time, t where S(t) = 0.01

- Restricted mean survival time (RMST) estimated at time horizon THpop

Methods

Simulated populations were created and nsim  = 5000 repetitions drawn. Each repetition included six levels of sample size, nobs = {30, 60, 90, 120, 250, 500}. Within each repetition and sample size, artificially censored datasets were created based on deciles of proportions of events, pe = {10%, 20%, …, 100%}, creating ten levels of follow-up.

Standard parametric distributions (exponential, Weibull, log-normal, log-logistic, generalized gamma and Gompertz) were fitted to each grouping for each repetition, nonconverging or implausible fits removed, and estimated model parameters (estimators) collected from extrapolated survival curves:

- Information criteria (IC) to determine the best-fitting distribution

- Median survival time, t where S(t) = 0.5

- One-year landmark survival probability, S(t) where t = 365 days

- Sample time horizon THi, (1% survival time), t where S(t) = 0.01

- Population time horizon RMST (RMST estimated at THpop)

- Sample time horizon RMST (RMST estimated at THi)

Performance measures

- Proportion identifying the true distribution as best fitting

- Coverage

- Error

 ◦ Mean absolute error (MAE)

 ◦ Mean absolute percentage error (MAPE)

 ◦ Root mean squared error (RMSE)

 ◦ Probability of 20% error