Adaptive Design Methods in Clinical Trials (Chapman & Hall/CRC Biostatistics Series)

Adaptive Design Methods in Clinical Trials (Chapman & Hall/CRC Biostatistics Series)
Shein-Chung Chow,Mark Chang | 2006-11-16 00:00:00 | Chapman and Hall/CRC | 296 | Pharmacology
Although adaptive design methods are flexible and useful in clinical research, little or no regulatory guidelines are available. One of the first books on the topic, Adaptive Design Methods in Clinical Trials presents the principles and methodologies in adaptive design and analysis that pertain to adaptations made to trial or statistical procedures that are based on accrued data of ongoing clinical trials. The book also offers a well-balanced summary of current regulatory perspectives and recently developed statistical methods in this area.

After an introduction to basic concepts and statistical considerations of adaptive design methods, the book questions the impact on target patient populations as the result of protocol amendments and discusses the generalization of statistical inference. The authors also present various adaptive design methods, including where hypotheses are modified during the conduct of clinical trials, for dose selection, and commonly used adaptive group sequential design methods in clinical trials. Following a discussion of blind procedures for sample size re-estimation, the book describes statistical tests for seamless phase II/III adaptive designs and statistical inference for switching adaptively from one treatment to another. The book concludes with computer simulations and various case studies of clinical trials.

By providing theoretical and computer simulation results, method comparisons, and practical guidelines for choosing an optimal design, Adaptive Design Methods in Clinical Trials fills the need for a unified, comprehensive, and updated resource in the clinical research and development of adaptive design and analysis.
Reviews
I used this book and accompanying software for about a year and was surprised, when opening the software, to be greeted with the message, "Your license will expire within 30 days. Please contact license@www.CTriSoft.net to renew it immediately." Neither the book, nor the accompanying CD mentions any expiration of the software. When I contacted the vendor, they offered a brief license extension, but going forward I would need to renew the license for $495 per year. When I contacted Wiley, their response was apologetic that they hadn't mentioned the limited life of the software, and that they would do nothing until the next reprinting (at an unspecified time in the future). It was unclear what they would do then.



Although there are some warts, I found the book and software to be useful. However, the book is not valuable without the software and if you plan to use the combination for more than a year, be prepared to pay several hundred dollars per annum to renew the software license.








Reviews
This book's best features are its bibliography (about 240 entries) and its broad survey and taxonomy of adaptive methods. Its publication represents an important step in popularizing adaptive trials and, thus, streamlining drug/device/biologic development pipelines.



The book is, however, filled with inaccuracies on several levels: incorrect grammar and equation references, undefined symbols, a reference to a non-existent appendix, unclear language (e.g., what is the "statistical strength for rejecting Ho" on Page 150?), mathematical typos [e.g., P(x|y,theta) rather than P(y|theta) in the integrand for the posterior predictive probability distribution P(y|x)], and misapplications of statistical philosophy (e.g., using Neyman-Pearson hypothesis testing for statistical inference, identifying the p-value as a post-hoc type I error rate). In the sample I took of about 1/3 of the pages, about 120 errors occur. The book should be considered only a pre-publication "beta" version. Any second edition should receive much more attention to detail.



A statistician or clinical scientist planning a potentially adaptive trial could use this book to learn about some of the aspects of a trial that can be made adaptive. The book could also help him/her to assess the assumptions and mathematical complexity of methods under consideration. However, when it comes to actually performing an analysis, one would want to use the bibliography to obtain the relevant articles and books, perhaps together with Chang's "Adaptive Design Theory and Implementation Using SAS and R" (Chapman & Hall/CRC Biostatistics).



Overall, this book disappointed me. The authors should have had several more collaborators and copyeditors check their work.
Reviews
I meet the second author, Mark Chang, at a conference on adaptive designs. I work as a professional statistician in the pharmaceutical industry. For the past several years, at least ten, these ideas have been the topic of research and it is being investigated as a possible way to speed up drug development and its development is being encouraged by the FDA. There has not been a formal statistical text covering the existing theory and its application to clinical trials. Consequently, when we knew this was coming out we preordered it and have been studying it since it came out last November.



The book has lived up to expectations. Adaptive designs are very similar to group sequential designs in that they have planned times to make preliminary assessment of the trial data and then decide whether or not to continue the trial or modify the design. Adaptive designs can be more flexible than their group sequential counterparts. They even can allow changes to the protocol as long as the criteria for making such changes are mapped out in advance of the trial.



These methods have been controversial in the past and simulation studies are often required to determine their properties. But there has been enough development now that some designs are being applied in real trials. In fact we are considering a two stage adaptive design similar to the ones described in this text (except applied to bioequivalence).



Later this year Mark Chang is coming out with an applied text that include SAS macros to aid in the implementation of the methods. A preview of the manuscript was displayed at an adaptive trials conference that I attended recently. I can enthusiastically recommend that one even more than this one! However, any biostatistician working on clinical trials should have this book on his or her bookshelf.

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