Practical recommendations for implementing a Bayesian adaptive phase I design during a pandemic

Ewings, S. and Saunders, G. and Jaki, T. and Mozgunov, P. (2022) Practical recommendations for implementing a Bayesian adaptive phase I design during a pandemic. BMC Medical Research Methodology, 22 (1). ISSN 1471-2288

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Abstract

Background: Modern designs for dose-finding studies (e.g., model-based designs such as continual reassessment method) have been shown to substantially improve the ability to determine a suitable dose for efficacy testing when compared to traditional designs such as the 3 + 3 design. However, implementing such designs requires time and specialist knowledge. Methods: We present a practical approach to developing a model-based design to help support uptake of these methods; in particular, we lay out how to derive the necessary parameters and who should input, and when, to these decisions. Designing a model-based, dose-finding trial is demonstrated using a treatment within the AGILE platform trial, a phase I/II adaptive design for novel COVID-19 treatments. Results: We present discussion of the practical delivery of AGILE, covering what information was found to support principled decision making by the Safety Review Committee, and what could be contained within a statistical analysis plan. We also discuss additional challenges we encountered in the study and discuss more generally what (unplanned) adaptations may be acceptable (or not) in studies using model-based designs. Conclusions: This example demonstrates both how to design and deliver an adaptive dose-finding trial in order to support uptake of these methods.

Item Type:
Journal Article
Journal or Publication Title:
BMC Medical Research Methodology
Uncontrolled Keywords:
/dk/atira/pure/subjectarea/asjc/2700/2713
Subjects:
ID Code:
165487
Deposited By:
Deposited On:
04 Feb 2022 15:40
Refereed?:
Yes
Published?:
Published
Last Modified:
05 May 2022 02:35