% Usage: Copy report.Rnw and ssafety.rda to a temporary directory and
% make directories gentex and pdf under it, then run knitr on report.Rnw
% To compile: knitr report; pdflatex report
% Produces: report.pdf
\documentclass{article}
\usepackage{knitrl}
\usepackage{moreverb} % for \verbatimtabinput
\usepackage{fancyhdr} % for fancy headers
\usepackage{url} % for \url{}
\usepackage{changepage} % for exReport \begin{adjustwidth}
\def\titl{Example Closed Meeting Data Monitoring Committee Report}
\definecolor{darkblue}{RGB}{0,0,139}
\def\linkcol{darkblue}
\usepackage[pdftex,hidelinks,bookmarks,pagebackref,pdfpagemode=UseOutlines,
colorlinks,linkcolor=\linkcol,
pdfauthor={Frank E Harrell Jr},
pdftitle={\titl}]{hyperref}
% Remove colorlinks and linkcolor options to hyperref to box the
% hyperlinked items (for screen only)
\def\poptype{3} % 0=no pop-up tooltips 1=ocgtools 2=movable pop-ups
% 3=no pop-ups, put as tiny tables in figure captions
\usepackage{greport}
\graphicspath{{pdf/}}
\newcommand{\code}[1]{\texttt{\smaller #1}} % format software names
% smaller implemented by relsize: use 1 size smaller than current font
\author{Frank Harrell}
\title{\titl}
\date{\today}
\pagestyle{fancy} % used for running headers, footers (rhead)
\renewcommand{\subsectionmark}[1]{} % suppress subsection titles in headers
\begin{document}
\maketitle
\tableofcontents
\listoffigures
\listoftables
\clearpage
\rhead{\scriptsize The {\em EXAMPLE} Study \\
Protocol xyz--001 \\
\today}
<>=
echo <- TRUE # include code in report
# echo <- FALSE # exclude code in report
cat('%------------------\n')
cat(sprintf('\\def\\inclcode{%s}\n', 1 * echo))
require(greport)
knitrSet(echo=echo)
@
<<>>=
Load(ssafety)
ssafety <- upData(ssafety, rdate=as.Date(rdate),
smoking=factor(smoking, 0:1, c('No','Yes')),
labels=c(smoking='Smoking', bmi='BMI',
pack.yrs='Pack Years', age='Age',
height='Height', weight='Weight'),
units=c(age='years', height='cm', weight='Kg'),
print=FALSE)
mtime <- function(f) format(file.info(f)$mtime)
datadate <- mtime('ssafety.rda')
primarydatadate <- mtime('ssafety.rda')
## List of lab variables that are missing too much to be used
omit <- Cs(amylase,aty.lymph,glucose.fasting,neutrophil.bands)
## Make a list that separates variables into major categories
vars <- list(baseline=Cs(age, sex, race, height, weight, bmi,
smoking, pack.yrs),
ae =Cs(headache, ab.pain, nausea, dyspepsia, diarrhea,
upper.resp.infect, coad),
ekg =setdiff(names(ssafety)[c(49:53,55:56)],
'atrial.rate'),
chem=setdiff(names(ssafety)[16:48],
c(omit, Cs(lymphocytes.abs, atrial.rate,
monocytes.abs, neutrophils.seg,
eosinophils.abs, basophils.abs))))
week <- ssafety$week
weeks <- sort(unique(week))
base <- subset(ssafety, week==0)
denom <- c(c(enrolled=500, randomized=nrow(base)), table(base$trx))
setgreportOption(tx.var='trx', denom=denom, texwhere='')
## Initialize app.tex
file <- sprintf('%s/app.tex', getgreportOption('texdir'))
cat('', file=file)
@
\section{Philosophy}
The reporting tools used here are based on a number of lessons learned
from the intersection of the fields of statistical graphics, graphic
design, and cognitive psychology, especially from the work of Bill Cleveland,
Ralph McGill, John Tukey, Edward Tufte, and Jacques Bertin.
\begin{enumerate}
\item Whenever largely numerical information is displayed, graphs
convey the information most often needed much better than tables.
\begin{enumerate}
\item Tables usually show more precision than is warranted by the
sample information while hiding important features.
\item Graphics are much better than tables for seeing patterns and
anomalies.
\end{enumerate}
\item The best graphics are ones that make use of features that humans are most
accurate in perceiving, namely position along a common scale.
\item Information across multiple data categories is usually easier to
judge when the categories are sorted by the numeric quantity
underlying the information\footnote{This also facilitates
multivariate understanding of trends and differences. For
example, if one sorted countries by the fraction of subjects who
died and displayed also the fraction of subjects who suffered a
stroke, the extent to which stroke incidence is also sorted by
country is a measure of the correlation between mortality and
stroke incidence across countries.}.
\item The most robust and informative descriptive statistics for
continuous variables are quantiles and whole distribution
summaries\footnote{In particular, the standard deviation is not very
meaningful for asymmetric distributions, and is not robust to outliers.}.
\item For group comparisons, confidence intervals for individual
means, medians, or proportions are not very useful, and whether or
not two confidence intervals overlap is not the correct statistical
approach for judging the significance of the difference between the
two. The half-width of the confidence interval for the difference,
when centered at the midpoint of the two estimates, provides a
succinct precision display, and this half-interval touches the
two estimates if and only if there is no significant difference
between the two.
\item Each graphic needs a marker that provides the reader with a
sense of exactly what fraction of the sample is being analyzed in
that graphic.
\item Tables are best used as backups to graphics.
\item Tables should emphasize estimates that are not functions of the
sample size. For categorical variables, proportions have
interpretations independent of sample size so they are the featured
estimates, and numerators and denominators are subordinate to the
proportions. For
continuous variables, minimum and maximum, while useful for data
quality checking, are not population parameters, and they expand as
$n\uparrow$, so they are not proper summary statistics.
\end{enumerate}
\section{Notation}
\ifnum\poptype > 0
\ifnum\poptype < 3
\paragraph{Pop-up Tooltips}
Certain elements of the report, signaled by
\textcolor[gray]{0.5}{$\mapsto$}, have pop-up tooltips behind them.
More information will pop up when viewing the report under Acrobat
Reader when the mouse hovers over \textcolor[gray]{0.5}{$\mapsto$}.
\ifnum\poptype=1
Clicking on the information in the pop-up will make it ``stick'', and
clicking on the \textcolor{red}{X} will make it disappear. For
graphics that have pop-up tables you can also click anywhere inside
the graph. When the pop-up is a wide table, it will use full-page
mode. If the table is tall you may need to scroll vertically. To do
that, click on the table when it pops up to make it stick, then
scroll, then click again to make it disappear.
\fi
\ifnum\poptype=2
Clicking on the pop-up and releasing will allow you to move the pop-up
with a mouse gesture (do not hold the mouse button down). Click on
the pop-up to make it stick in a certain location. Hover over
\textcolor[gray]{0.5}{$\mapsto$} to make the pop-up disappear, or
click on the pop-up again to unstick it.
\fi
\fi
\fi
\paragraph{Hyperlinks and Tables}
Some graphics and tables are hyperlinked to tables
in the Appendix. For these, clicking anywhere in the graphic or table
will move the pdf reader to the supporting table. Clicking on the
appendix table will bring you back to the original figure.
\ifnum\pdfstrcmp{\linkcol}{black}=0
%
\else
Other than for graphics, objects appearing in
\textcolor{\linkcol}{this color} are hyperlinked.
\fi
\paragraph{Viewers}
You must use Adobe Acrobat Reader to view pdf files generated by
\code{greport}, otherwise pop-ups will not work. Neither pop-ups nor
hyperlinks will work if you view documents in a Web browser window.
It is recommended that you click on \texttt{View \dots Page Display
\dots Single Page} for optimum jumping between hyperlinks, i.e., do
not use \texttt{Single Page Continuous} mode.
\paragraph{Figure Captions}
Needles represent the fraction of observations used in the current
analysis. The first needle (red) shows the fraction of enrolled
patients used. If randomization was taken into account, a second
needle (green) represents the fraction of randomized subjects included
in the analysis. When the analyses consider treatment assignment, two
more needles may be added to the display, showing, respectively, the
fraction of subjects randomized to treatment A used in the analysis
and the fraction of subjects on treatment B who were analyzed. The
colors of these last two needles are the colors used for the two
treatments throughout the report. The following table shows some
examples.
<>=
# dNeedle uses colors in setgreportOption(tx.col=, er.col=)
dNeedle(1, 'lttdemoa')
dNeedle(c(3,4)/4 , 'lttdemob')
dNeedle(c(1,2)/4, 'lttdemoc')
dNeedle(c(1,2,3,1)/4,'lttdemod')
@
\begin{center}
\begin{tabular}{ll}
\textbf{Needles} & \textbf{Interpretation} \\ \hline
\lttdemoa & All enrolled subjects analyzed, randomization not considered\\
\lttdemob & Analysis uses $\frac{3}{4}$ of enrolled subjects,
and all randomized subjects\\
\lttdemoc & Analysis uses $\frac{1}{4}$ of enrolled subjects,
and $\frac{1}{2}$ of randomized subjects\\
\lttdemod & Same as previous example, and in addition the analysis\\
& utilized treatment assignment, analyzing $\frac{3}{4}$ of
those\\
& randomized to A and $\frac{1}{4}$ of those randomized to B\\
\hline
\end{tabular}
\end{center}
\ifnum\poptype > 0
\ifnum\poptype < 3
There are pop-up tooltips embedded in the needles. When hovering the
mouse over \textcolor[gray]{0.5}{$\mapsto$} a table of subject counts
will pop up.
\fi
\fi
\paragraph{Extended Box Plots}
% For poptype 1 and 2:
%\newcommand{\eboxpopup}[1]{\tooltipm{#1}{\includegraphics{bpplt-proto-1}}}
% For poptype 3:
\newcommand{\eboxpopup}[1]{\hyperlink{bpplt}{#1}}
% To not generate pop-up use: \newcommand{\eboxpopup}[1]{}
For depicting distributions of continuous variables, many of the
following displays use extended box plots, also called
box--percentile plots. The plots are scaled to the marginal 0.01 and
0.99 quantiles of the variables. A prototype, with explanations, is
below. When viewing the report, hovering the
mouse over the word ``box'' will pop up this prototype as needed.
<>=
bpplt()
@
\hypertarget{bpplt}{}
Typically violin plots are superimposed onto box plots in what
follows. Violin plots show mirror images of the estimated probability
density function for continuous variable, using a kernel density
estimator. Violin plots are better able to show multimodality than
quantile intervals.
\paragraph{Dot Charts}
Dot charts are used to present stratified proportions. In these
charts the area of the symbols is proportional to the square root of
the denominator. The legend shows representative denominators and
their corresponding symbol areas, using denominators that actually
occurred in the data and extended from the minimum observed to the
maximum observed sample size.
\paragraph{Longitudinal Analysis}
For continuous variables measured repeatedly, line plots show the
median as a function of time. Next to each point is a series of thin
vertical lines, one series on the left for treatment A and another
series on the right for treatment B, when stratifying by treatment.
Moving outward from the point showing the median, these lines depict
the following quantile intervals---the same ones depicted in the
extended box plots.
\def\quantint{
\begin{tabular}{crclc} \hline
Horizontal & \multicolumn{3}{c}{Quantiles} & Fraction of\\
Sequence & \multicolumn{3}{c}{Spanned} & Sample Covered \\ \hline
~~~~~~$1$ & $\frac{1}{20}$ &-& $\frac{19}{20}$ & $\frac{9}{10}$ \\
~~~~$2$ & $\frac{1}{8}$ &-& $\frac{7}{8}$ & ~~$\frac{3}{4}$ \\
~~$3$ & $\frac{1}{4}$ &-& $\frac{3}{4}~$ & ~~~~$\frac{1}{2}$ \\
$4$ & $\frac{3}{8}$ &-& $\frac{5}{8}$ & ~~~~~~$\frac{1}{4}$ \\ \hline
\end{tabular}
}
\begin{center}
\quantint\hypertarget{quantint}{}
\end{center}
%\newcommand{\qintpopup}[1]{\tooltipn{#1}{\quantint}}
\newcommand{\qintpopup}{\hyperlink{quantint}{these~}}
% To not generate pop-up use \newcommand{\qintpopup}[1]{}
\ifnum\poptype > 0
\ifnum\poptype < 3
These definitions will pop-up when hovering the mouse at the end of
the phrase ``quantile intervals'' in captions.
\fi
\fi
In addition there is a black vertical line centered at the midpoint of
the two medians, with height equal to $\frac{1}{2}$ of the width of an
approximate 0.95 confidence interval for the difference in the two
medians. When the two medians touch this vertical bar, there is
approximately no significant difference in the medians at the 0.05
level. The Harrell--Davis quantile estimator is used, along with its
standard error estimate for the median.
Instead of quantile intervals, longitudinal plots may show vertical
violin plots. Unlike the mirror--image violin plots shown on box
plots, there there are two groups being compared the first group has a
half-violin plot on the left of the point showing the median, and the
second group has a half-violin plot on the right. Back--to--back
comparisons of probability density functions are useful for comparing
entire distributions of continuous variables. When for a group the
sample size is less than 10 the violins are more faint, and when the
sample size is less than 5 they are barely visible.
For binary variables measured repeatedly, the 0.95 Wilson confidence
intervals are shown on either side of the proportions, and a vertical
black line appears over the proportions. The height of this line is
$\frac{1}{2}$ the length of the normal-approximation 0.95 confidence
interval for the difference in the two proportions. When the
proportions fail to touch this line, they are approximately
significantly different at (at least) the 0.05 level.
For discrete variables that are not binary, such as adverse event
presence and severity, means and bootstrap percentile 0.95 confidence
intervals are shown, along with half-confidence intervals for the
difference in means using as standard error the square root of the sum
of squares of the two means' standard errors.
\paragraph{Survival Curves}
Graphs containing pairs of Kaplan-Meier survival curves show a shaded
region centered at the midpoint of the two survival estimates and
having a height equal to the half-width of the approximate 0.95 pointwise
confidence interval for the difference of the two survival
probabilities. Time points at which the two survival estimates do not
touch the shaded region denote approximately significantly different
survival estimates, without any multiplicity correction.
\clearpage
\section{Introduction}
This is a sample of the part of a closed meeting Data Monitoring
Committee report that contains software generated results. Components
related to efficacy, study design, data monitoring
plan,\footnote{Lan-DeMets monitoring bounds can be plotted using the
open source \R\ \code{gsDesign} package.}
summary of previous closed report, interpretation, protocol changes,
screening, eligibility, and waiting time until treatment commencement
are not included in this example\footnote{See Ellenberg, Fleming, and
DeMets, \emph{Data Monitoring Committees in Clinical Trials} (Wiley,
2002), pp.\ 73-74 for recommended components in open and closed data
monitoring committee reports.}. This report used a random sample of
safety data from a randomized clinical trial. Randomization date,
dropouts, and compliance variables were simulated, the latter two not
being made consistent with the presence or absence of actual data in
the random sample. The date and time that the analysis file used here
was last updated was \Sexpr{datadate}. Source analysis files were last
updated on \Sexpr{primarydatadate}.
\ifnum\inclcode=1{
See Section~\ref{program} for information about software used.
\LaTeX's \code{hyperref} style was used to produce a \code{pdf}
file with hyperlinks for easy navigation to sections, tables, and
graphs using Adobe Acrobat Reader. Internal hyperlinks are shown in
\linkcol, and external links to web sites are shown in red.
}\fi
%See the example open meeting report for subject accrual, data
%availability and completeness, and analyses not stratified by
%treatment.
\section{Accrual}
<>=
accrualReport(randomize(rdate) ~ site(site), data=base,
dateRange=c('1990-01-01','1994-12-31'),
targetDate='1994-12-31', targetN=300,
closeDate=max(base$rdate))
@
\clearpage
\section{Baseline Variables}
<>=
dReport(sex + race + smoking ~ trx, groups='trx', data=base,
h=4, w=3.5)
## Show spike histogram for raw data, 50 bins
dReport(age + height + weight + bmi + pack.yrs ~ trx, data=base,
h=3.5,
sopts=list(datadensity=TRUE,
scat1d.opts=list(nhistSpike=1,
col=adjustcolor('red', alpha.f=.5),
nint=50)),
append=TRUE)
@
\clearpage
%\section{Compliance to Assigned Treatments}
%complianceReport(ssafety$comply, ssafety$trx, ssafety$week,
% weeks[weeks > 1])
%\section{Dropouts}
%dropoutReport(base$d.dropout, base$dropout, base$trx, time.inc=14)
\section{Longitudinal Adverse Events}
<>=
dReport(headache + ab.pain + nausea + dyspepsia + diarrhea +
upper.resp.infect + coad ~ week + trx + id(id),
groups='trx', data=ssafety, panel='longae', what='byx',
popts=list(cex.strip=.57,
key=list(x=.65, y=.2, lines=TRUE, points=FALSE)))
@
\clearpage
\section{Incidence of Adverse Events at Any Follow-up}
<>=
## Reformat to one record per event per subject per time
aev <- vars$ae
ev <- ssafety[ssafety$week > 0, c(aev, 'trx', 'id', 'week')]
## Reshape to tall and thin format
evt <- reshape(ev, direction='long', idvar=c('id', 'week'),
varying=aev, v.names='sev', timevar='event',
times=aev)
## For each event, id and trx see if event occurred at any week
ne <- with(evt, summarize(sev, llist(id, trx, event),
function(y) any(y > 0, na.rm=TRUE)))
## Remove non-occurrences of events
ne <- subset(ne, sev, select=c(id, trx, event))
## Replace event names with event labels
elab <- sapply(ssafety[aev], label)
ne$event <- elab[ne$event]
label(ne$trx) <- 'Treatment'
eReport(event ~ trx, data=ne, h=3.25)
@
\clearpage
\section{Longitudinal EKG Data}
<>=
dReport(axis + corr.qt + pr + qrs + uncorr.qt + hr ~ week + trx +
id(id),
groups='trx', data=ssafety, panel='ekg', what='byx', w=7)
@
\clearpage
\section{Longitudinal Clinical Chemistry Data}
<>=
## Plot 6 variables per page
cvar <- split(vars$chem, rep(letters[1:4], each=6))
for(subpanel in names(cvar)) {
form <- paste(cvar[[subpanel]], collapse=' + ')
form <- as.formula(paste(form, 'week + trx + id(id)', sep=' ~ '))
dReport(form, groups='trx', data=ssafety, panel='cchem',
subpanel=subpanel,
what='byx', append=subpanel != 'a',
popts=list(cex.strip=.7), w=7)
}
## Repeat last figure using quantile intervals instead of violin densities
dReport(form, groups='trx', data=ssafety, panel='cchem',
subpanel='e', what='byx', byx.type='quantiles', append=TRUE,
popts=list(cex.strip=.7), w=7)
@
\clearpage % needed to get last tooltips to work
\section{Computing Environment}
These analyses were done using the following versions of R\cite{Rsystem}, the
operating system, and add-on packages \code{greport}\cite{greport},
\code{Hmisc}\cite{Hmisc}, \code{rms}\cite{rrms}, and others:
<>=
toLatex(sessionInfo(), locale=FALSE)
@
The reproducible research framework \code{knitr}~\cite{knitrbook} was used.
\bibliography{feh.bib}
\bibliographystyle{unsrt}
\clearpage
\section{Appendix: Supporting Tables}
\input{gentex/app}
\clearpage
\ifnum\inclcode=1{
\section{Programming}\label{program}
\subsection{Methods}
This report was produced using high-quality open source, freely
available \R\ and \LaTeX\ packages. High-level \R\ graphics and \LaTeX\
making functions in FE Harrell's \code{Hmisc} package were used in the
context of the \R\ \code{knitr} package.
A new \R\ package \code{greport} contains functions
%\code{completeness\-Report},
\code{accrual\-Report},
\code{dReport}, %\code{rep\-Varclus},
%\code{compliance\-Report}, \code{dropout\-Report},
\code{ex\-Report}, \code{e\-Report}, and \code{surv\-Report}
using the philosophy of program-controlled generation of \LaTeX\ text,
figures, and tables. When figures were plotted in \R, \LaTeX\ figure
legends and graphics insertion macro calls were automatically
generated.
%Some of the functions produce both open (with pooling of
%treatment groups) and closed (stratifying on treatment) meeting reports.
%Automatically created graphics and \code{.tex} files for
%the open report have names beginning with \code{O}.
The \code{.pdf} file containing the report was generated using
\code{pdflatex} so as to automatically generate hyperlinks (shown in
blue) to all the figures and tables for easy navigation when viewing
on the screen. If using pop-up method \code{poptype=1},
the user must install the following \LaTeX\ packages:
\code{acrotex}, \code{ocgtools}, and \code{asymptote}. If using
\code{poptype=2}, the user must install the \code{tooltip} style.
See \url{http://biostat.mc.vanderbilt.edu/Greport} for more information.
\code{poptype=3} just puts the denominator information as tiny tables
in figure captions and don't require use of any special \LaTeX\
packages. This approach solves a problem with Macs and Ipads not
handling pop-ups correctly.
Before running the \R\ code to produce the report components, create the
following directories underneath your project directory: \code{pdf}
and \code{gentex}, to hold \code{pdf} graphics and generated \LaTeX\
code, respectively. You can change the name of these directories
using the \code{setgreportOption} function.
The entire process is best managed by creating a single \code{.Rnw}
file that is executed using the \code{knitr} package in \R.
\textbf{Note}: When using \code{knitr} with
\code{cache=TRUE} it is assumed that no cached chunks produce appendix
tables. For debugging, it is recommended that slow chunks be cached,
then to make sure the entire appendix is generated turn off all
caching and re-run the program.
The user musc define a function \code{spar} using the one in
\url{http://biostat.mc.vanderbilt.edu/wiki/pub/Main/RConfiguration/Rprofile}
as a template. \code{spar} sets good default graphical parameters
(e.g., space between axis labels and axes) for non-\code{lattice} \R\
graphics. The \code{Rprofile} example there also defines the
\code{knitrSet} function that is used in this example, to pretty-print
\R\ code.
\subsection{Changing Lattice Graphics Parameters}
The most common change needed in Lattice graphics is the font size in strip labels, especially to allow longer labels to fit. Here is a summary of how to change this in a few \code{greport} contexts.
\begin{description}
\item[violin and box plots with \code{dReport}]: \code{sopts=list(cex.strip=.6)}
\item[Proportion charts with \code{dReport}]: \code{popts=list(par.strip=list(cex=.6))}
\end{description}
\subsection{Data Preparation}
Variable labels are used in much of the graphical and tabular output,
so it is advisable to attach \code{label} attributes to almost all
variables. Variable names are used when \code{label}s are not
defined. Units of measurement also appear in the output, so most
continuous variables should have a \code{units} attribute. The
\code{units} may contain mathematical expressions such as \verb|cm^2|
which will be properly typeset in tables and plots, using
superscripts, subscripts, etc. Variables that are not binary (0/1,
\code{Y/N}, etc.) but are categorical should have \code{levels} (value
labels) defined (e.g., using the \code{factor} function) that will be
attractive in the report. The Hmisc library \code{upData} function is
useful for annotating variables with labels, units of measurement, and
value labels. See
\href{http://biostat.mc.vanderbilt.edu/wiki/pub/Main/RS/sintro.pdf}
{Alzola and Harrell, 2006},
\href{http://biostat.mc.vanderbilt.edu/StatGraphCourse}, and
\href{http://biostat.mc.vanderbilt.edu/StatCompCourse} for details
about setting up analysis files.
\R\ code that created the analysis file for this report is shown
below. For this particular application, \code{units} and some of
the \code{labels} were actually obtained from separate data tables
as shown in the code.
\subsubsection{Data Assumptions}
\begin{enumerate}
\item Non-randomized subjects are marked by missing data of randomization
\item The treatment variable is always the same for every dataset
and is defined in \code{tx.var} on \code{setgreportOption}.
\item For some graphics there must be either no treatment variable
or exactly two treatment levels.
\item If there are treatments the design is a parallel-group design.
\item Whenever a dataset is specified to one of the \code{greport}
functions and subject have repeated measurements ($>1$ record), an
\code{id} variable must be given.
\end{enumerate}
\subsection{User \code{knitr} Source File for This Document}
{\small\verbatimtabinput{report.Rnw}}
}\fi
\end{document}