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arXiv 2304.03035stat.ME
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平台试验中的最优分配策略

Optimal allocation strategies in platform trials

Marta Bofill Roig, Ekkehard Glimm, Tobias Mielke, Martin Posch

AI总结:

针对共享对照平台试验的患者分配难题,推导了校正时间趋势下的最优分配率,明确其与经典√k规则不同,并通过案例验证了其在检验效能和I类错误率上的表现。

摘要:

平台试验是一类随机化临床试验,可同时对多种干预措施与共同对照进行比较。用于测试实验性干预的试验组可随时间进入或退出平台,这意味着试验中的实验性干预组数量可能随时间变化。确定平台试验中分配患者至治疗组和对照组的最优分配率极具挑战性,因为治疗组的变动意味着当治疗方案进入或退出平台时,最优分配率也会随之改变。此外,最优分配还取决于所采用的分析策略。\n本文针对采用共享对照的平台试验,推导了最优治疗分配率,前提是使用基于回归模型的分层估计与检验程序来校正时间趋势。我们同时考虑了仅使用同期对照的分析方法,以及也纳入非同期对照的分析方法,并假设总样本量固定。待最小化的目标函数是效应估计量方差的最大值。研究表明,最优解取决于试验组的入组时间,且通常不等同于经典多臂试验中使用的√k分配规则。我们通过案例研究阐释了最优分配方案,并评估了其与采用1:1分配和√k分配的试验相比的检验效能和I类错误率。

英文摘要:

Platform trials are randomized clinical trials that allow simultaneous comparison of multiple interventions, usually against a common control. Arms to test experimental interventions may enter and leave the platform over time. This implies that the number of experimental intervention arms in the trial may change over time. Determining optimal allocation rates to allocate patients to the treatment and control arms in platform trials is challenging because the change in treatment arms implies that also the optimal allocation rates will change when treatments enter or leave the platform. In addition, the optimal allocation depends on the analysis strategy used. In this paper, we derive optimal treatment allocation rates for platform trials with shared controls, assuming that a stratified estimation and testing procedure based on a regression model, is used to adjust for time trends. We consider both, analysis using concurrent controls only as well as analysis methods based on also non-concurrent controls and assume that the total sample size is fixed. The objective function to be minimized is the maximum of the variances of the effect estimators. We show that the optimal solution depends on the entry time of the arms in the trial and, in general, does not correspond to the square root of $k$ allocation rule used in the classical multi-arm trials. We illustrate the optimal allocation and evaluate the power and type 1 error rate compared to trials using one-to-one and square root of $k$ allocations by means of a case study.

机构、总结、中文摘要均由AI分析而来,可能存在错误,请以论文正文为准。

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