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Chapter 13 - Common Misconceptions of Adaptive Trial Designs and Master Protocols

from Part V - A Practical Guide to Adaptive Trial Designs and Master Protocols

Published online by Cambridge University Press:  20 March 2023

Jay J. H. Park ,
Edward J. Mills  and
J. Kyle Wathen
By
Jay J. H. Park ,
Edward J. Mills  and
J. Kyle Wathen
Jay J. H. Park
Affiliation:
McMaster University, Ontario
Edward J. Mills
Affiliation:
McMaster University, Ontario
J. Kyle Wathen
Affiliation:
Cytel, Cambridge, Massachusetts
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Summary

In this chapter, we review ten common misconceptions of adaptive trial designs and master protocols encountered during our collective experience in teaching and working in the field of clinical trial research.

Keywords

adaptive trial designsmaster protocolsmisconceptions
Type
Chapter
Information
Introduction to Adaptive Trial Designs and Master Protocols , pp. 149 - 159
Publisher: Cambridge University Press
Print publication year: 2023

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References

Mueller, PS, Montori, VM, Bassler, D, Koenig, BA, Guyatt, GH. Ethical issues in stopping randomized trials early because of apparent benefit. Ann Int Med. 2007;146(12):878–81.Google Scholar
Guyatt, GH, Briel, M, Glasziou, P, Bassler, D, Montori, VM. Problems of stopping trials early. BMJ. 2012;344:e3863.Google Scholar
Bassler, D, Montori, VM, Briel, M, Glasziou, P, Guyatt, G. Early stopping of randomized clinical trials for overt efficacy is problematic. J Clin Epidemiol. 2008;61(3):241–6.Google Scholar
Briel, M, Bassler, D, Wang, AT, Guyatt, GH, Montori, VM. The dangers of stopping a trial too early. J Bone Joint Surg Am. 2012;94(Suppl 1):56–60.Google Scholar
Pocock, SJ, Hughes, MD. Practical problems in interim analyses, with particular regard to estimation. Control Clin Trials. 1989;10(4 Suppl):209S–21S.Google Scholar
Fan, XF, DeMets, DL, Lan, KK. Conditional bias of point estimates following a group sequential test. J Biopharm Stat. 2004;14(2):505–30.CrossRefGoogle ScholarPubMed
Goodman, SN. Stopping at nothing? Some dilemmas of data monitoring in clinical trials. Ann Int Med. 2007;146(12):882–7.Google Scholar
Viele, K, McGlothlin, A, Broglio, K. Interpretation of clinical trials that stopped early. Jama. 2016;315(15):1646–7.Google Scholar
Flight, L, Julious, S, Brennan, A, Todd, S. Expected value of sample information to guide the design of group sequential clinical trials. Med Decis Making. 2022;42(4):461–73.CrossRefGoogle ScholarPubMed
Dimairo, M, Boote, J, Julious, SA, Nicholl, JP, Todd, S. Missing steps in a staircase: a qualitative study of the perspectives of key stakeholders on the use of adaptive designs in confirmatory trials. Trials. 2015;16(1):1–16.Google Scholar
Jaki, T. Uptake of novel statistical methods for early-phase clinical studies in the UK public sector. Clin Trials. 2013;10(2):344–6.Google Scholar
Madani Kia, T, Marshall, JC, Murthy, S. Stakeholder perspectives on adaptive clinical trials: a scoping review. Trials. 2020;21(1):539.Google Scholar
He, W, Kuznetsova, OM, Harmer, M, et al. Practical considerations and strategies for executing adaptive clinical trials. DIJ. 2012;46(2):160–74.Google Scholar
Dimairo, M, Pallmann, P, Wason, J, et al. The adaptive designs CONSORT extension (ACE) statement: a checklist with explanation and elaboration guideline for reporting randomised trials that use an adaptive design. Trials. 2020;21(1):528.Google Scholar
Dimairo, M, Pallmann, P, Wason, J, et al. The Adaptive designs CONSORT Extension (ACE) statement: a checklist with explanation and elaboration guideline for reporting randomised trials that use an adaptive design. BMJ. 2020;369:m115.Google Scholar
Detry, MA, Lewis, RJ, Broglio, KR, et al. Standards for the design, conduct, and evaluation of adaptive randomized clinical trials. Patient-Centered Outcomes Research Institute (PCORI); 2012.Google Scholar
Mayer, C, Perevozskaya, I, Leonov, S, et al. Simulation practices for adaptive trial designs in drug and device development.Stat Biopharm Res. 2019;11(4):325–35.Google Scholar
Thorlund, K, Haggstrom, J, Park, JJ, Mills, EJ. Key design considerations for adaptive clinical trials: a primer for clinicians. BMJ. 2018;360:k698.Google Scholar
Bhatt, DL, Mehta, C. Adaptive designs for clinical trials. N Engl J Med. 2016;375(1):65–74.Google Scholar
Berry, DA. Bayesian clinical trials. Nat Rev Drug Discov. 2006;5(1):27–36.Google Scholar
Senn, S. You may believe you are a Bayesian but you are probably wrong. Error Statistics Philosophy; 2011.Google Scholar
Tversky, A, Kahneman, D. Judgment under uncertainty: heuristics and biases. Science. 1974;185(4157):1124–31.Google Scholar
Dave, C, Wolfe, KW. On confirmation bias and deviations from Bayesian updating. Working Paper, University of Pittsburgh; 2004.Google Scholar
Johnson, AA, Ott, MQ, Dogucu, M. Bayes Rules!: An Introduction to Applied Bayesian Modeling. CRC Press; 2022.Google Scholar
Woolston, C. Psychology journal bans P values. Nature. 2015;519(7541):9.Google Scholar
Singh Chawla, D. ‘One-size-fits-all’ threshold for P values under fire. Nature News. 2017.Google Scholar
Yarnell, CJ, Abrams, D, Baldwin, MR, et al. Clinical trials in critical care: can a Bayesian approach enhance clinical and scientific decision making? Lancet Resp Med. 2021;9(2):207–16.Google Scholar
Greenland, S, Senn, SJ, Rothman, KJ, et al. Statistical tests, P values, confidence intervals, and power: a guide to misinterpretations. Eur J Epidemiol. 2016;31(4):337–50.Google Scholar
Wagenmakers, EJ. A practical solution to the pervasive problems of p values. Psychon Bull Rev. 2007;14(5):779–804.Google Scholar
Berry, DA. Interim analysis in clinical trials: the role of the likelihood principle. Am Stat. 1987;41(2):117–22.Google Scholar
United States Department of Health and Human Services, Food and Drug Administration. Master Protocols: Efficient Clinical Trial Design Strategies to Expedite Development of Oncology Drugs and Biologics Guidance for Industry.United States Department of Health and Human Services; 2022. www.fda.gov/media/120721/download.Google Scholar
United States Department of Health and Human Services, Food and Drug Administration. Adaptive Designs for Clinical Trials of Drugs and Biologics. Guidance for Industry. Center for Biologics Evaluation and Research (CBER). 2019.Google Scholar
United States Department of Health and Human Services, Food and Drug Administration. Master Protocols: Efficient Clinical Trial Design Strategies to Expedite Development of Oncology Drugs and Biologics Guidance for Industry (Draft Guidance). United States Department of Health and Human Services; 2018 www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM621817.pdfGoogle Scholar
Proschan, M, Evans, S. Resist the temptation of response-adaptive randomization. Clin Infect Dis. 2020;71(11):3002–4.Google Scholar
Angus, DC. Optimizing the trade-off between learning and doing in a pandemic. JAMA. 2020;323(19):1895–6.Google Scholar
Meurer, WJ, Lewis, RJ, Berry, DA. Adaptive clinical trials: a partial remedy for the therapeutic misconception? JAMA. 2012;307(22):2377–8.Google Scholar
Thall, P, Fox, P, Wathen, J. Statistical controversies in clinical research: scientific and ethical problems with adaptive randomization in comparative clinical trials. Ann Oncol. 2015;26(8):1621–8.CrossRefGoogle ScholarPubMed
Viele, K, Broglio, K, McGlothlin, A, Saville, BR. Comparison of methods for control allocation in multiple arm studies using response adaptive randomization. Clin Trials. 2020;17(1):52–60.Google Scholar
Zhao, W, Durkalski, V. Managing competing demands in the implementation of response‐adaptive randomization in a large multicenter phase III acute stroke trial. Stat Med. 2014;33(23):4043–52.Google Scholar
Wason, JM, Brocklehurst, P, Yap, C. When to keep it simple – adaptive designs are not always useful. BMC Med. 2019;17(1):1–7.Google Scholar
Senn, S. Being efficient about efficacy estimation. Stat Biopharm Res. 2013;5(3):204–10.Google Scholar
Park, JJH, Harari, O, Dron, L, et al. An overview of platform trials with a checklist for clinical readers. J Clin Epidemiol. 2020;125:1–8.Google Scholar
Hague, D, Townsend, S, Masters, L, et al. Changing platforms without stopping the train: experiences of data management and data management systems when adapting platform protocols by adding and closing comparisons. Trials. 2019;20(1):1–16.Google Scholar
Schiavone, F, Bathia, R, Letchemanan, K, et al. This is a platform alteration: a trial management perspective on the operational aspects of adaptive and platform and umbrella protocols. Trials. 2019;20(1):264.Google Scholar
Yusuf, S, Collins, R, Peto, R. Why do we need some large, simple randomized trials? Stat Med. 1984;3(4):409–20.Google Scholar
Siden, EG, Park, JJ, Zoratti, MJ, et al. Reporting of master protocols towards a standardized approach: a systematic review. Contemp Clin Trials Commun. 2019;15:100406.Google Scholar
Woodcock, J, LaVange, LM. Master protocols to study multiple therapies, multiple diseases, or both. N Engl J Med. 2017;377(1):62–70.Google Scholar
Park, JJH, Siden, E, Zoratti, MJ, et al. Systematic review of basket trials, umbrella trials, and platform trials: a landscape analysis of master protocols. Trials. 2019;20(1):572.Google Scholar
Park, JJH, Hsu, G, Siden, EG, Thorlund, K, Mills, EJ. An overview of precision oncology basket and umbrella trials for clinicians. CA Cancer J Clin. 2020;70(2):125–37.Google Scholar
Simon, R. Optimal two-stage designs for phase II clinical trials. Control Clin Trials. 1989;10(1):1–10.Google Scholar
Park, JJH, Detry, MA, Murthy, S, Guyatt, G, Mills, EJ. How to use and interpret the results of a platform trial: users’ guide to the medical literature. JAMA. 2022;327(1):67–74.Google Scholar
Bauer, P, Bretz, F, Dragalin, V, Konig, F, Wassmer, G. Twenty-five years of confirmatory adaptive designs: opportunities and pitfalls. Stat Med. 2016;35(3):325–47.Google Scholar
Bogin, V. Master protocols: new directions in drug discovery. Contemp Clin Trials Commun. 2020;18:100568.CrossRefGoogle ScholarPubMed
Grieve, AP. Response-adaptive clinical trials: case studies in the medical literature. Pharm Stat. 2017;16(1):64–86.Google Scholar
Angus, DC, Alexander, BM, Berry, S, et al. Adaptive platform trials: definition, design, conduct and reporting considerations. Nat Rev Drug Discov. 2019;18(10):797–808.Google Scholar
Wathen, JK, Thall, PF. A simulation study of outcome adaptive randomization in multi-arm clinical trials. Clin Trials. 2017;14(5):432–40.Google Scholar

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