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A default method to specify skeletons for Bayesian model averaging continual reassessment method for phase I clinical
Haitao Pan1,2, Ying Yuan1
1Department of Biostatistics, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, 77030, TX, U.S.A.
This study introduces a default method for selecting skeletons in Bayesian model averaging continual reassessment method (CRM) dose-finding trials. The approach enhances model selection accuracy for determining the maximum tolerated dose.
Area of Science:
- Biostatistics
- Clinical Trials
- Pharmacometrics
Background:
- The continual reassessment method (CRM) is a dose-finding design used in clinical trials.
- Bayesian model averaging (BMA) enhances CRM robustness by using multiple models (skeletons).
- Specifying multiple skeletons for BMA-CRM can be challenging for practitioners.
Purpose of the Study:
- To propose a default method for specifying skeletons in BMA-CRM.
- To define a measure of skeleton nonequivalence.
- To optimize skeleton selection for accurate maximum tolerated dose (MTD) identification.
Main Methods:
- Developed a default skeleton specification strategy for BMA-CRM.
- Introduced a nonequivalence measure to quantify differences between skeletons.
- Extended model calibration to select optimal skeletons maximizing correct MTD selection and ensuring sufficient nonequivalence.
Main Results:
- Skeletons that appear different can represent equivalent models.
- The proposed method for skeleton selection demonstrated desirable operating characteristics in simulations.
- The approach ensures sufficient nonequivalence among selected skeletons.
Conclusions:
- The proposed default skeleton specification and selection method improves BMA-CRM performance.
- This approach simplifies the practical application of BMA-CRM for dose-finding studies.
- Software is provided to implement the proposed method for clinical trial design.
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