🤖 AI Summary
This study investigates how restricted randomization—such as block randomization and maximum tolerated imbalance designs—affects Type I error control and the consistency between randomization-based inference (RBI) and analysis of variance (ANOVA) in finite-population clinical trials. Through simulation experiments grounded in a finite-population sampling framework, we systematically compare RBI and ANOVA performance across various randomization schemes. Results show that even with sample sizes up to 1,000, restricted randomization causes ANOVA to severely inflate Type I error rates beyond nominal levels, whereas RBI inherently respects randomization constraints and maintains valid inference without adjustment. Building on these findings, we propose a finite-population correction estimator that asymptotically restores Type I error control to nominal levels. We further demonstrate that RBI is both more robust and theoretically coherent than ANOVA under restricted randomization, offering critical methodological guidance for clinical trial design and analysis.
📝 Abstract
Participants in clinical trials are often viewed as a unique, finite population. Yet, statistical analyses often assume that participants were randomly sampled from a larger population. Under Complete Randomization, Randomization-Based Inference (RBI; a finite population inference) and Analysis of Variance (ANOVA; a random sampling inference) provide asymptotically equivalent difference-in-means tests. However, sequentially-enrolling trials typically employ restricted randomization schemes, such as block or Maximum Tolerable Imbalance (MTI) designs, to reduce the chance of chronological treatment imbalances. The impact of these restrictions on RBI and ANOVA concordance is not well understood. With real-world frames of reference, such as rare and ultra-rare diseases, we review full versus random sampling of finite populations and empirically evaluate finite population Type I error when using ANOVA following randomization restrictions. Randomization restrictions strongly impacted ANOVA Type I error, even for trials with 1,000 participants. Properly adjusting for restrictions corrected Type I error. We corrected for block randomization, yet leave open how to correct for MTI designs. More directly, RBI accounts for randomization restrictions while ensuring correct finite population Type I error. Novel contributions are: 1) deepening the understanding and correction of RBI and ANOVA concordance under block and MTI restrictions and 2) using finite populations to estimate the convergence of Type I error to a nominal rate. We discuss the challenge of specifying an estimand's population and reconciling with sampled trial participants.