Multivariate Rank-Based Analysis of Multiple Endpoints in Clinical Trials: A Global Test Approach

Abstract: Clinical trials often involve the assessment of multiple endpoints to comprehensively evaluate the efficacy and safety of interventions. In the work, we consider a global nonparametric testing procedure based on multivariate rank for the analysis of multiple endpoints in clinical trials. Unlike other existing approaches that rely on pairwise comparisons for each individual endpoint, the proposed method directly incorporates the multivariate ranks of the observations. By considering the joint ranking of all endpoints, the proposed approach provides robustness against diverse data distributions and censoring mechanisms commonly encountered in clinical trials. Through extensive simulations, we demonstrate the superior performance of the multivariate rank-based approach in controlling type I error and achieving higher power compared to existing rank-based methods. The simulations illustrate the advantages of leveraging multivariate ranks and highlight the robustness of the approach in various settings. The proposed method offers an effective tool for the analysis of multiple endpoints in clinical trials, enhancing the reliability and efficiency of outcome evaluations.