Discretization in covariate-adaptive randomization: gains and losses

๐Ÿ“… 2026-09-09
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็ ”็ฉถๆŽข่ฎจไบ†ๅœจๅๅ˜้‡้€‚ๅบ”้šๆœบๅŒ–ไธญ็ฆปๆ•ฃๅŒ–่ฟž็ปญๅๅ˜้‡็š„ๅฝฑๅ“๏ผŒ้€š่ฟ‡็†่ฎบๅˆ†ๆžๅ’Œๅฎž่ฏ็ ”็ฉถๆๅ‡บ็ฆปๆ•ฃๅŒ–ๅขžๅผบ็จณๅฅๆ€งไฝ†ๅฏ่ƒฝ้™ไฝŽๆ•ˆ็އใ€‚
๐Ÿ“ Abstract
Covariate-adaptive randomization(CAR) is widely implemented in clinical trials to balance prognostic covariates across treatment arms. Continuous covariates are often discretized into strata in practice, yet their consequences are not clearly understood. This paper provides a comprehensive study of the impact of discretization on both the CAR design process and the inferential results thereafter. We establish the asymptotic properties of both imbalance measures and treatment effect estimators under discretized and non-discretized settings. Practical recommendations are given on when and how discretization should be employed. We show that discretization in design is generally recommended, as it enhances robustness against model misspecification. However, if the true model is known, the most efficient strategy is to balance covariates according to that model in the design. The theoretical results are corroborated by extensive simulation studies and an empirical application to a diabetes trial dataset. Together, the results clarify the gains and losses of discretization in CAR and pave the way for learning impact of discretization to other designs and beyond.
Problem

Research questions and friction points this paper is trying to address.

Covariate-adaptive randomization
discretization
continuous covariates
treatment arms
inferential results
Innovation

Methods, ideas, or system contributions that make the work stand out.

Covariate-adaptive randomization
Discretization
Asymptotic properties
Model misspecification
Treatment effect estimators
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Zixuan Zhao
Department of Statistics, George Washington University
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Feifang Hu
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