Subgroup analysis methods for time-to-event outcomes in heterogeneous randomized controlled trials

Abstract: Non-significant randomized control trials can hide subgroups of good responders to experimental drugs, thus hindering subsequent development. Identifying such heterogeneous treatment effects is key for precision medicine and many post-hoc analysis methods have been developed for that purpose. While several benchmarks have been carried out to identify the strengths and weaknesses of these methods, notably for binary and continuous endpoints, similar systematic empirical evaluation of subgroup analysis for time-to-event endpoints are lacking. This work aims to fill this gap by evaluating several subgroup analysis algorithms in the context of time-to-event outcomes, by means of three different research questions: Is there heterogeneity? What are the biomarkers responsible for such heterogeneity? Who are the good responders to treatment? In this context, we propose a new synthetic and semi-synthetic data generation process that allows one to explore a wide range of heterogeneity scenarios with precise control on the level of heterogeneity. We provide an open source Python package, available on Github, containing our generation process and our comprehensive benchmark framework. We hope this package will be useful to the research community for future investigations of heterogeneity of treatment effects and subgroup analysis methods benchmarking.