Skip to main content

Advertisement

Log in

Adaptive Designs for Clinical Trials with Highly Successful Treatments

  • Published:
Drug information journal : DIJ / Drug Information Association Aims and scope Submit manuscript

Abstract

We compare the performance of two adaptive designs and equal allocation in a clinical trial with two highly successful treatments and binary outcomes. The measure of interest in the trial is the odds ratio. The goal of the adaptive design is to decrease the total number of failures compared to equal allocation while keeping the power at the same level. One design is based on sequential maximum likelihood estimation, the other on an urn model. We find that the urn model produces a better procedure than the sequential maximum likelihood approach and equal allocation, in that it yields fewer expected treatment failures, maintains the power of the asymptotic test, and is more powerful when the Fisher’s exact test is used. We conclude that adaptive designs have attractive properties when both treatments are highly successful.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Friedman LM, Furberg CD, DeMets DL. Fundamentals of Clinical Trials. Boston, MA: Wright PSG; 1981, 41.

    Google Scholar 

  2. Melfi V, Page C. Variability in adaptive designs for estimation of success probabilities. In New Developments and Applications in Experimental Design. Flournoy N, Rosenberger WF, Wong WK, eds. Hay-ward, CA: Institute of Mathematical Statistics: 1998, 106–114.

    Chapter  Google Scholar 

  3. Ivanova AV, Rosenberger WF. A comparison of urn designs for randomized clinical trials of K > 2 treatments. J Biopharm Stat. 2000;10:93–107.

    Article  CAS  Google Scholar 

  4. Rosenberger WF, Stallard N, Inanova A, Harper C, Ricks M. Optimal adaptive designs for binary response trials. Biometrics. 2001;57:833–837.

    Article  Google Scholar 

  5. Jennison C, Turnbull BW. Group Sequential Methods with Applications to Clinical Trials. Boca Raton, FL: Chapman and Hall/CRC; 2000, 329.

    Google Scholar 

  6. The COMPASS Investigators. Randomized double-blind study comparing saruplase with streptokinase in acute myocardial infarction: the COMPASS equivalence trial. J Am Coll Cardiol. 1998;31:487–493.

    Article  Google Scholar 

  7. Connor EM, Sperling RS, Gelber R, Kiselev P, Scott G, O’Sullivan MJ, VanDyke R, Bey M, Shearer W, Jacobson RL, Jiminez E, O’Neil E, Bazin B, Del-fraissy J, Culnane M, Coombs R, Elkins M, Moye J, Stratton P, Balsley J for the Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. New Engl J Med. 1994;331:1173–1180.

    Article  CAS  Google Scholar 

  8. Rosenberger WF, Seshaiyer P. Adaptive survival trials. J Biopharm Stat. 1997;7:617–624.

    Article  CAS  Google Scholar 

  9. Rosenberger WF. Randomized play-the-winner clinical trials: review and recommendations. Control Clin Trials. 1999;20:328–335.

    Article  CAS  Google Scholar 

  10. Wei LJ, Durham S. The randomized play-the-winner rule in medical trials. J Am Stat Assoc. 1978;73: 840–843.

    Article  Google Scholar 

  11. Ivanova AV, Rosenberger WF, Durham SD, Flournoy N. A birth and death urn for randomized clinical trials: asymptotic results. Sankhya B. 2000;62:104–118.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Grant support: For Professor Rosenberger, R29-DK51015-05 from the National Institute of Diabetes and Digestive and Kidney Diseases. This was an invited paper presented by the second author at the Pharmaceutical Research and Manufacturers Association/Food and Drug Administration Workshop, November 1, 2000, Washington, District of Columbia.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ivanova, A., Rosenberger, W.F. Adaptive Designs for Clinical Trials with Highly Successful Treatments. Ther Innov Regul Sci 35, 1087–1093 (2001). https://doi.org/10.1177/009286150103500406

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1177/009286150103500406

Key Words

Navigation