On Exact Unconditional Test for Linear Trend in Dose-Response Studies

The one‐degree‐of‐freedom Cochran‐Armitage (C‐A) test statistic for linear trend has been widely applied in various dose‐response studies (e.g., anti‐ulcer medications and short‐term antibiotics, animal carcinogenicity bioassays and occupational toxicant studies). This approximate statistic relies, however, on asymptotic theory that is reliable only when the sample sizes are reasonably large and well balanced across dose levels. For small, sparse, or skewed data, the asymptotic theory is suspect and exact conditional method (based on the C‐A statistic) seems to provide a dependable alternative. Unfortunately, the exact conditional method is only practical for the linear logistic model from which the sufficient statistics for the regression coefficients can be obtained explicitly. In this article, a simple and efficient recursive polynomial multiplication algorithm for exact unconditional test (based on the C‐A statistic) for detecting a linear trend in proportions is derived. The method is applicable for all choices of the model with monotone trend including logistic, probit, arcsine, extreme value and one hit. We also show that this algorithm can be easily extended to exact unconditional power calculation for studies with up to a moderately large sample size. A real example is given to illustrate the applicability of the proposed method.