Comparing treatment strategies using a synthesized clinical trial: an analysis of late versus early use of trimethoprim-sulfamethoxazole for AIDS patients

This paper applies methodology of Finkelstein and Schoenfeld [Stat. Med. 13 (1994) 1747.] to consider new treatment strategies in a synthetic clinical trial. The methodology is an approach for estimating survival functions as a composite of subdistributions defined by an auxiliary event which is intermediate to the failure. The subdistributions are usually calculated utilizing all subjects in a study, by taking into account the path determined by each individual's auxiliary event. However, the method can be used to get a composite estimate of failure from different subpopulations of patients. We utilize this application of the methodology to test a new treatment strategy, that changes therapy at later stages of disease, by combining subdistributions from different treatment arms of a clinical trial that was conducted to test therapies for prevention of pneumocystis carinii pneumonia. (C) 2001 Elsevier Science B.V. All rights reserved.