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Full-Text Articles in Physical Sciences and Mathematics
Optimized Adaptive Enrichment Designs For Multi-Arm Trials: Learning Which Subpopulations Benefit From Different Treatments, Jon Arni Steingrimsson, Joshua Betz, Tiachen Qian, Michael Rosenblum
Optimized Adaptive Enrichment Designs For Multi-Arm Trials: Learning Which Subpopulations Benefit From Different Treatments, Jon Arni Steingrimsson, Joshua Betz, Tiachen Qian, Michael Rosenblum
Johns Hopkins University, Dept. of Biostatistics Working Papers
We consider the problem of designing a randomized trial for comparing two treatments versus a common control in two disjoint subpopulations. The subpopulations could be defined in terms of a biomarker or disease severity measured at baseline. The goal is to determine which treatments benefit which subpopulations. We develop a new class of adaptive enrichment designs tailored to solving this problem. Adaptive enrichment designs involve a preplanned rule for modifying enrollment based on accruing data in an ongoing trial. The proposed designs have preplanned rules for stopping accrual of treatment by subpopulation combinations, either for efficacy or futility. The motivation …
Phase Ii Adaptive Enrichment Design To Determine The Population To Enroll In Phase Iii Trials, By Selecting Thresholds For Baseline Disease Severity, Yu Du, Gary L. Rosner, Michael Rosenblum
Phase Ii Adaptive Enrichment Design To Determine The Population To Enroll In Phase Iii Trials, By Selecting Thresholds For Baseline Disease Severity, Yu Du, Gary L. Rosner, Michael Rosenblum
Johns Hopkins University, Dept. of Biostatistics Working Papers
We propose and evaluate a two-stage, phase 2, adaptive clinical trial design. Its goal is to determine whether future phase 3 (confirmatory) trials should be conducted, and if so, which population should be enrolled. The population selected for phase 3 enrollment is defined in terms of a disease severity score measured at baseline. We optimize the phase 2 trial design and analysis in a decision theory framework. Our utility function represents a combination of the cost of conducting phase 3 trials and, if the phase 3 trials are successful, the improved health of the future population minus the cost of …
Stochastic Optimization Of Adaptive Enrichment Designs For Two Subpopulations, Aaron Fisher, Michael Rosenblum
Stochastic Optimization Of Adaptive Enrichment Designs For Two Subpopulations, Aaron Fisher, Michael Rosenblum
Johns Hopkins University, Dept. of Biostatistics Working Papers
An adaptive enrichment design is a randomized trial that allows enrollment criteria to be modified at interim analyses, based on a preset decision rule. When there is prior uncertainty regarding treatment effect heterogeneity, these trial designs can provide improved power for detecting treatment effects in subpopulations. We present a simulated annealing approach to search over the space of decision rules and other parameters for an adaptive enrichment design. The goal is to minimize the expected number enrolled or expected duration, while preserving the appropriate power and Type I error rate. We also explore the benefits of parallel computation in the …
Sensitivity Of Trial Performance To Delay Outcomes, Accrual Rates, And Prognostic Variables Based On A Simulated Randomized Trial With Adaptive Enrichment, Tiachen Qian, Elizabeth Colantuoni, Aaron Fisher, Michael Rosenblum
Sensitivity Of Trial Performance To Delay Outcomes, Accrual Rates, And Prognostic Variables Based On A Simulated Randomized Trial With Adaptive Enrichment, Tiachen Qian, Elizabeth Colantuoni, Aaron Fisher, Michael Rosenblum
Johns Hopkins University, Dept. of Biostatistics Working Papers
Adaptive enrichment designs involve rules for restricting enrollment to a subset of the population during the course of an ongoing trial. This can be used to target those who benefit from the experimental treatment. To leverage prognostic information in baseline variables and short-term outcomes, we use a semiparametric, locally efficient estimator, and investigate its strengths and limitations compared to standard estimators. Through simulation studies, we assess how sensitive the trial performance (Type I error, power, expected sample size, trial duration) is to different design characteristics. Our simulation distributions mimic features of data from the Alzheimer’s Disease Neuroimaging Initiative, and involve …