6.7 Problems
Problem 6.7.1. How many subjects are needed in each of two equal groups of a cohort study to detect a doubling of a five-year risk of \(0.05\), at \(\alpha = 0.05\) with power \(0.90\)?
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Solution. \(\pi _1 = 0.10\), \(\pi _0 = 0.05\), \(\bar \pi = 0.075\), \(z_\beta = 1.282\). Then \begin {gather*} \sigma _0 = \sqrt {2 \times 0.075 \times 0.925} = 0.3725, \\ \sigma _1 = \sqrt {0.10 \times 0.90 + 0.05 \times 0.95} = 0.3708, \\ n = \frac {(1.960 \times 0.3725 + 1.282 \times 0.3708)^2}{0.05^2} = 581.3 \end {gather*} so \(582\) in each group after rounding up, \(1164\) in all.
Problem 6.7.2. A cohort study has \(500\) exposed and \(500\) unexposed subjects. What is its power to detect risks of \(0.15\) against \(0.10\) at \(\alpha = 0.05\)?
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Solution. \(\delta = 0.05\), \(\sigma _0 = \sqrt {2 \times 0.125 \times 0.875} = 0.468\), \(\sigma _1 = \sqrt {0.1275 + 0.09} = 0.466\). The power is \(\Phi \{(0.05\sqrt {500} - 1.96 \times 0.468)/0.466\} = \Phi (0.431) = 0.67\). The study has only a two-in-three chance of detecting a risk ratio of \(1.5\).
Problem 6.7.3. Only \(100\) cases are available for a case-control study of an exposure with prevalence \(0.2\) among controls. Find the power to detect an odds ratio of \(2\) with \(1\), \(3\) and \(10\) controls per case.
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Solution. With \(q_1 = 0.333\) and \(q_0 = 0.2\), the power formula of Theorem 6.4.1 with \(n = 100\) gives \(0.57\) for \(k = 1\), \(0.76\) for \(k = 3\) and \(0.84\) for \(k = 10\). Tripling the controls raises the power substantially; going from \(3\) to \(10\) adds much less, as Proposition 6.2.1 predicts. Even with unlimited controls the power would stay below \(0.9\), because the \(100\) cases fix the first term of the variance.
Problem 6.7.4. In Example 6.3.2 there are also \(18\) pairs in which both are exposed and \(40\) in which neither is. Compute the crude odds ratio from the \(100\) cases and \(100\) controls, ignoring the matching, and compare it with \(\hat \psi = 2.5\).
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Solution. Exposed cases: \(n_{11} + n_{10} = 18 + 30 = 48\); exposed controls: \(n_{11} + n_{01} = 18 + 12 = 30\). The crude odds ratio is \((48 \times 70)/(52 \times 30) = 3360/1560 = 2.15\). It is closer to \(1\) than the matched estimate. Pairs are alike in the matching variable, which here is associated with exposure, and ignoring the matching treats the controls as if they were a random sample of the base when they have been drawn towards the cases’ exposure distribution.
Problem 6.7.5. A cohort study is planned to detect a rate ratio of \(1.5\) with power \(0.90\) at \(\alpha = 0.05\). The rate among the unexposed is \(4\) per \(1000\) person-years, and exposed and unexposed will contribute equal person-time. How many cases and how many person-years are needed?
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Solution. \(\pi = 1.5/2.5 = 0.6\), so \(D = (1.960 + 1.282)^2/\{0.24\,(\log 1.5)^2\} = 10.51/(0.24 \times 0.1644) = 266\) cases. Each pair of exposed and unexposed person-years yields \(0.004 + 0.006 = 0.010\) cases, so about \(26{,}600\) person-years are needed in each group. A modest effect on a rare outcome needs a large cohort.
Problem 6.7.6. Show that in Proposition 6.2.1 the variance with \(k\) controls per case and \(m_1\) cases equals the variance with \(k = 1\) and \(m_1' = 2m_1 k/(k + 1)\) cases when \(q_1 = q_0\). Interpret.
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Solution. With \(q_1 = q_0 = q\) the variance is \((1 + 1/k)/\{m_1 q(1 - q)\}\), and with \(k = 1\) and \(m_1'\) cases it is \(2/\{m_1' q(1 - q)\}\). These are equal when \(m_1' = 2m_1/(1 + 1/k) = 2m_1 k/(k + 1)\). With four controls per case, \(100\) cases are worth \(160\) cases with one control each: extra controls substitute for cases, but at most \(100\) cases with unlimited controls are worth \(200\) matched one-to-one.
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