An adaptive design for identifying the dose with the best efficacy/tolerability profile with application to a crossover dose-finding study.
Stat Med
; 28(24): 2941-51, 2009 Oct 30.
Article
in En
| MEDLINE
| ID: mdl-19731265
ABSTRACT
Proof-of-concept in clinical trials has traditionally focused on the identification of a maximum tolerated dose with the assumption that the higher doses provide better efficacy. However, adverse events associated with a maximum tolerated dose may have a negative effect on efficacy. We present an efficient adaptive dose-finding strategy that concentrates patient assignments at and around the dose which has the best efficacy/tolerability profile based on a utility function. The strategy is applied within the setting of a crossover design. While the strategy may also be applied to parallel studies, a crossover design provides more power for a given sample size for comparisons between the optimal dose versus placebo and/or active control when it is reasonable to assume no carryover effects.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pharmaceutical Preparations
/
Clinical Trials, Phase II as Topic
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Stat Med
Year:
2009
Type:
Article
Affiliation country:
United States