使用短期终点来改善中间决策和试验持续时间,在两个阶段的II期试验中使用嵌套的二元终点
Dario Zocholl1, Cornelia U Kunz2, Geraldine Rauch1
1Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Biometry and Clinical Epidemiology, Berlin, Germany.
Statistical methods in medical research
|July 25, 2023
概括
新方法通过使用所有患者数据进行临时决定来提高II期瘤学试验的功率. 这些方法提高了统计能力,特别是在缓慢招募的试验中,通过避免误导性的早期停止.
科学领域:
- 临床试验 临床试验
- 生物统计学 生物统计学
- 瘤学研究研究
背景情况:
- 第二阶段瘤学试验通常使用双阶段设计,具有二进制终点.
- 西蒙的设计很受欢迎,但由于后续时间,可能导致长时间的试验中断.
- 如果假设被错误指定,使用短期终点进行临时决策可能会导致误导结果.
研究的目的:
- 在两阶段瘤学试验中提出临时决定的新方法.
- 提高统计能力,避免因错误指定短期终点而过早关闭试验.
- 利用所有可用的患者结局数据,以获得更准确的试验指导.
主要方法:
- 开发了两种方法:条件力和贝叶斯后置预测概率.
- 用短期和长期终点评估来进行临时决策.
- 进行了广泛的模拟,以评估方法性能和功率.
主要成果:
- 两种拟议的方法在校准时都显示出类似的性能.
- 与现有方法相比,这些方法显著提高了统计能力.
- 这些方法在患者招募缓慢的试验中尤为有益.
结论:
- 拟议的方法为二期瘤学试验中的中间分析提供了可靠的替代方案.
- 准确利用所有患者数据可以提高试验的效率和可靠性.
- 公开可用的软件有助于实施这些先进的统计技术.
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