A cluster‐adjusted rank‐based test for a clinical trial concerning multiple endpoints with application to dietary intervention assessment

A novel longitudinal rank-sum test for multiple primary endpoints in clinical trials: Applications to neurodegenerative disorders

Neurodegenerative disorders such as Alzheimer's disease (AD) present a significant global health challenge, characterized by cognitive decline, functional impairment, and other debilitating effects. Current AD clinical trials often assess multiple longitudinal primary endpoints to comprehensively evaluate treatment efficacy. Traditional methods, however, may fail to capture global treatment effects, require larger sample sizes due to multiplicity adjustments, and may not fully exploit multivariate longitudinal data. To address these limitations, we introduce the Longitudinal Rank Sum Test (LRST), a novel nonparametric rank-based omnibus test statistic. The LRST enables a comprehensive assessment of treatment efficacy across multiple endpoints and time points without multiplicity adjustments, effectively controlling Type I error while enhancing statistical power. It offers flexibility against various data distributions encountered in AD research and maximizes the utilization of longitudinal data. Extensive simulations and real-data applications demonstrate the LRST's performance, underscoring its potential as a valuable tool in AD clinical trials. Nonparametrics, Global test, rank-sum-type test, U-Statistics.

Directional-sum test for nonparametric Behrens-Fisher problem with applications to the dietary intervention trial

For a nonparametric Behrens-Fisher problem, a directional-sum test is proposed based on division-combination strategy. A one-layer wild bootstrap procedure is given to calculate its statistical significance. We conduct simulation studies with data generated from lognormal, t and Laplace distributions to show that the proposed test can control the type I error rates properly and is more powerful than the existing rank-sum and maximum-type tests under most of the considered scenarios. Applications to the dietary intervention trial further show the performance of the proposed test.