Atrial fibrillation (AF) is a rapid and unorganized beating of the upper chambers of the heart.  It is generally not life-threatening in the short term, but it dramatically impacts how a patient feels, and it can have bad consequences in the long term.  One of those “bad consequences” is stroke, caused by blood clots that can form in the atria when they are “fibrillating” for long periods of time, and the clots subsequently flow to the brain.  We are now planning a study to see whether a new therapy (perhaps cryoablation plus a new drug) is better than a control therapy (perhaps cryotherapy plus an old drug) at preventing stroke or death.  Our primary endpoint will be a composite of stroke or all-cause mortality, and we will structure this as a time-to-event analysis. We think the new therapy will lead to a reduction in risk of 40% (that is, a hazard ratio of 0.60).  How many events must we observe (combined across both therapy groups) in order to have 95% power to detect a reduction of this magnitude?  (You may assume alpha = 0.05 and a 1:1 allocation ratio.) At the end of 5 years of follow-up we expect that 20% of our patient population (combined across treatment groups) will have died or had a stroke.  How many subjects should we plan to enroll?

Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN:9780134580999
Author:Elaine N. Marieb, Katja N. Hoehn
Publisher:Elaine N. Marieb, Katja N. Hoehn
Chapter1: The Human Body: An Orientation
Section: Chapter Questions
Problem 1RQ: The correct sequence of levels forming the structural hierarchy is A. (a) organ, organ system,...
icon
Related questions
Question

Atrial fibrillation (AF) is a rapid and unorganized beating of the upper chambers of the heart.  It is generally not life-threatening in the short term, but it dramatically impacts how a patient feels, and it can have bad consequences in the long term.  One of those “bad consequences” is stroke, caused by blood clots that can form in the atria when they are “fibrillating” for long periods of time, and the clots subsequently flow to the brain.  We are now planning a study to see whether a new therapy (perhaps cryoablation plus a new drug) is better than a control therapy (perhaps cryotherapy plus an old drug) at preventing stroke or death.  Our primary endpoint will be a composite of stroke or all-cause mortality, and we will structure this as a time-to-event analysis.

  1. We think the new therapy will lead to a reduction in risk of 40% (that is, a hazard ratio of 0.60).  How many events must we observe (combined across both therapy groups) in order to have 95% power to detect a reduction of this magnitude?  (You may assume alpha = 0.05 and a 1:1 allocation ratio.)
  2. At the end of 5 years of follow-up we expect that 20% of our patient population (combined across treatment groups) will have died or had a stroke.  How many subjects should we plan to enroll?
Expert Solution
trending now

Trending now

This is a popular solution!

steps

Step by step

Solved in 2 steps

Blurred answer
Knowledge Booster
Cardiovascular system
Learn more about
Need a deep-dive on the concept behind this application? Look no further. Learn more about this topic, biology and related others by exploring similar questions and additional content below.
Similar questions
  • SEE MORE QUESTIONS
Recommended textbooks for you
Human Anatomy & Physiology (11th Edition)
Human Anatomy & Physiology (11th Edition)
Biology
ISBN:
9780134580999
Author:
Elaine N. Marieb, Katja N. Hoehn
Publisher:
PEARSON
Biology 2e
Biology 2e
Biology
ISBN:
9781947172517
Author:
Matthew Douglas, Jung Choi, Mary Ann Clark
Publisher:
OpenStax
Anatomy & Physiology
Anatomy & Physiology
Biology
ISBN:
9781259398629
Author:
McKinley, Michael P., O'loughlin, Valerie Dean, Bidle, Theresa Stouter
Publisher:
Mcgraw Hill Education,
Molecular Biology of the Cell (Sixth Edition)
Molecular Biology of the Cell (Sixth Edition)
Biology
ISBN:
9780815344322
Author:
Bruce Alberts, Alexander D. Johnson, Julian Lewis, David Morgan, Martin Raff, Keith Roberts, Peter Walter
Publisher:
W. W. Norton & Company
Laboratory Manual For Human Anatomy & Physiology
Laboratory Manual For Human Anatomy & Physiology
Biology
ISBN:
9781260159363
Author:
Martin, Terry R., Prentice-craver, Cynthia
Publisher:
McGraw-Hill Publishing Co.
Inquiry Into Life (16th Edition)
Inquiry Into Life (16th Edition)
Biology
ISBN:
9781260231700
Author:
Sylvia S. Mader, Michael Windelspecht
Publisher:
McGraw Hill Education