Do Bayesian adaptive trials offer advantages for comparative effectiveness research? Protocol for the RE-ADAPT study

Jason T. Connor, Bryan R. Luce, Kristine R. Broglio, K. Jack Ishak, C. Daniel Mullins, David J. Vanness, Rachael Fleurence, Elijah Saunders, Barry R. Davis

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background Randomized clinical trials, particularly for comparative effectiveness research (CER), are frequently criticized for being overly restrictive or untimely for health-care decision making. Purpose Our prospectively designed REsearch in ADAptive methods for Pragmatic Trials (RE-ADAPT) study is a proof of concept to stimulate investment in Bayesian adaptive designs for future CER trials. Methods We will assess whether Bayesian adaptive designs offer potential efficiencies in CER by simulating a re-execution of the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) study using actual data from ALLHAT. Results We prospectively define seven alternate designs consisting of various combinations of arm dropping, adaptive randomization, and early stopping and describe how these designs will be compared to the original ALLHAT design. We identify the one particular design that would have been executed, which incorporates early stopping and information-based adaptive randomization. Limitations While the simulation realistically emulates patient enrollment, interim analyses, and adaptive changes to design, it cannot incorporate key features like the involvement of data monitoring committee in making decisions about adaptive changes. Conclusion This article describes our analytic approach for RE-ADAPT. The next stage of the project is to conduct the re-execution analyses using the seven prespecified designs and the original ALLHAT data. Clinical Trials 2013; 10: 807-827. http:// ctj.sagepub.com.

Original languageEnglish (US)
Pages (from-to)807-827
Number of pages21
JournalClinical Trials
Volume10
Issue number5
DOIs
StatePublished - Oct 1 2013

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Pragmatic Clinical Trials
Comparative Effectiveness Research
Antihypertensive Agents
Myocardial Infarction
Lipids
Random Allocation
Research
Decision Making
Clinical Trials Data Monitoring Committees
Therapeutics
Randomized Controlled Trials
Clinical Trials
Delivery of Health Care

All Science Journal Classification (ASJC) codes

  • Pharmacology

Cite this

Connor, Jason T. ; Luce, Bryan R. ; Broglio, Kristine R. ; Ishak, K. Jack ; Mullins, C. Daniel ; Vanness, David J. ; Fleurence, Rachael ; Saunders, Elijah ; Davis, Barry R. / Do Bayesian adaptive trials offer advantages for comparative effectiveness research? Protocol for the RE-ADAPT study. In: Clinical Trials. 2013 ; Vol. 10, No. 5. pp. 807-827.
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Connor, JT, Luce, BR, Broglio, KR, Ishak, KJ, Mullins, CD, Vanness, DJ, Fleurence, R, Saunders, E & Davis, BR 2013, 'Do Bayesian adaptive trials offer advantages for comparative effectiveness research? Protocol for the RE-ADAPT study', Clinical Trials, vol. 10, no. 5, pp. 807-827. https://doi.org/10.1177/1740774513497293

Do Bayesian adaptive trials offer advantages for comparative effectiveness research? Protocol for the RE-ADAPT study. / Connor, Jason T.; Luce, Bryan R.; Broglio, Kristine R.; Ishak, K. Jack; Mullins, C. Daniel; Vanness, David J.; Fleurence, Rachael; Saunders, Elijah; Davis, Barry R.

In: Clinical Trials, Vol. 10, No. 5, 01.10.2013, p. 807-827.

Research output: Contribution to journalArticle

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AU - Luce, Bryan R.

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AU - Mullins, C. Daniel

AU - Vanness, David J.

AU - Fleurence, Rachael

AU - Saunders, Elijah

AU - Davis, Barry R.

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N2 - Background Randomized clinical trials, particularly for comparative effectiveness research (CER), are frequently criticized for being overly restrictive or untimely for health-care decision making. Purpose Our prospectively designed REsearch in ADAptive methods for Pragmatic Trials (RE-ADAPT) study is a proof of concept to stimulate investment in Bayesian adaptive designs for future CER trials. Methods We will assess whether Bayesian adaptive designs offer potential efficiencies in CER by simulating a re-execution of the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) study using actual data from ALLHAT. Results We prospectively define seven alternate designs consisting of various combinations of arm dropping, adaptive randomization, and early stopping and describe how these designs will be compared to the original ALLHAT design. We identify the one particular design that would have been executed, which incorporates early stopping and information-based adaptive randomization. Limitations While the simulation realistically emulates patient enrollment, interim analyses, and adaptive changes to design, it cannot incorporate key features like the involvement of data monitoring committee in making decisions about adaptive changes. Conclusion This article describes our analytic approach for RE-ADAPT. The next stage of the project is to conduct the re-execution analyses using the seven prespecified designs and the original ALLHAT data. Clinical Trials 2013; 10: 807-827. http:// ctj.sagepub.com.

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