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Covariate adjustment is an important tool in the analysis of randomized clinical trials and observational studies. It can be used to increase efficiency and thus power, and to reduce possible bias. While most statistical tests in randomized clinical trials are nonparametric in nature, approaches for covariate adjustment typically rely on specific regression models, such as the linear model for a continuous outcome, the logistic regression model for a dichotomous outcome and the Cox model for survival time. Several recent efforts have focused on model-free covariate adjustment. This paper makes use of the empirical likelihood method and proposes a nonparametric approach to covariate adjustment. A major advantage of the new approach is that it automatically utilizes covariate information in an optimal way without fitting nonparametric regression. The usual asymptotic properties, including the Wilks-type result of convergence to a chi-square distribution for the empirical likelihood ratio based test, and asymptotic normality for the corresponding maximum empirical likelihood estimator, are established. It is also shown that the resulting test is asymptotically most powerful and that the estimator for the treatment effect achieves the semiparametric efficiency bound. The new method is applied to the Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO)-I trial. Extensive simulations are conducted, validating the theoretical findings.
In randomized clinical trials, adjustments for baseline covariates at both design and analysis stages are highly encouraged by regulatory agencies. A recent trend is to use a model-assisted approach for covariate adjustment to gain credibility and ef
Concerns have been expressed over the validity of statistical inference under covariate-adaptive randomization despite the extensive use in clinical trials. In the literature, the inferential properties under covariate-adaptive randomization have bee
We argue that randomized controlled trials (RCTs) are special even among settings where average treatment effects are identified by a nonparametric unconfoundedness assumption. This claim follows from two results of Robins and Ritov (1997): (1) with
Phase III randomized clinical trials play a monumentally critical role in the evaluation of new medical products. Because of the intrinsic nature of uncertainty embedded in our capability in assessing the efficacy of a medical product, interpretation
We present a general framework for using existing data to estimate the efficiency gain from using a covariate-adjusted estimator of a marginal treatment effect in a future randomized trial. We describe conditions under which it is possible to define