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Familywise error control in multi-armed response-adaptive trials.

Accepted version
Peer-reviewed

Type

Article

Change log

Abstract

Response-adaptive designs allow the randomization probabilities to change during the course of a trial based on cumulated response data so that a greater proportion of patients can be allocated to the better performing treatments. A major concern over the use of response-adaptive designs in practice, particularly from a regulatory viewpoint, is controlling the type I error rate. In particular, we show that the naïve z-test can have an inflated type I error rate even after applying a Bonferroni correction. Simulation studies have often been used to demonstrate error control but do not provide a guarantee. In this article, we present adaptive testing procedures for normally distributed outcomes that ensure strong familywise error control by iteratively applying the conditional invariance principle. Our approach can be used for fully sequential and block randomized trials and for a large class of adaptive randomization rules found in the literature. We show there is a high price to pay in terms of power to guarantee familywise error control for randomization schemes with extreme allocation probabilities. However, for proposed Bayesian adaptive randomization schemes in the literature, our adaptive tests maintain or increase the power of the trial compared to the z-test. We illustrate our method using a three-armed trial in primary hypercholesterolemia.

Description

Keywords

Bayesian methods, closed testing, multiple comparisons, response-adaptive randomization, type I error, Adaptive Clinical Trials as Topic, Bias, Computer Simulation, Humans, Hypercholesterolemia, Models, Statistical, Random Allocation, Research Design

Journal Title

Biometrics

Conference Name

Journal ISSN

0006-341X
1541-0420

Volume Title

75

Publisher

Oxford University Press (OUP)
Sponsorship
Biometrika Trust (Unknown)
DSR and JMSW were funded by the Medical Research Council, grant code MC_UU_00002/6. DSR was also funded by the Biometrika Trust.