Improving operating characteristics of clinical trials by augmenting control arm using propensity score-weighted borrowing-by-parts power prior

TL;DR

This paper introduces a Bayesian method combining propensity score weighting and flexible power priors to improve clinical trial estimates by effectively borrowing external data while controlling bias.

Contribution

The paper proposes the PSW-BPP approach that integrates causal adjustment with differential Bayesian borrowing, enhancing robustness and efficiency in external data incorporation.

Findings

PSW-BPP improves estimation efficiency over no borrowing.

The method maintains robustness under covariate imbalance.

Simulation shows better stability and accuracy.

Abstract

Borrowing external data can improve estimation efficiency but may introduce bias when populations differ in covariate distributions or outcome variability. A proper balance needs to be maintained between the two datasets to justify the borrowing. We propose a propensity score weighting borrowing-by-parts power prior (PSW-BPP) that integrates causal covariate adjustment through propensity score weighting with a flexible Bayesian borrowing approach to address these challenges in a unified framework. The proposed approach first applies propensity score weighting to align the covariate distribution of the external data with that of the current study, thereby targeting a common estimand and reducing confounding due to population heterogeneity. The weighted external likelihood is then incorporated into a Bayesian model through a borrowing-by-parts power prior, which allows distinct power parameters for the mean and variance components of the likelihood, enabling differential and calibrated information borrowing. Additionally, we adopt the idea of the minimal plausibility index (mPI) to calculate the power parameters. This separate borrowing provides greater robustness to prior-data conflict compared with traditional power prior methods that impose a single borrowing parameter. We study the operating characteristics of PSW-BPP through extensive simulation and a real data example. Simulation studies demonstrate that PSW-BPP yields more efficient and stable estimation than no borrowing and fixed borrowing, particularly under moderate covariate imbalance and outcome heterogeneity. The proposed framework offers a principled and extensible methodological contribution for Bayesian inference with external data in observational and hybrid study designs.