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Point estimation for adaptive trial designs I: A methodological review

Robertson, David S; Choodari-Oskooei, Babak; Dimairo, Munya; Flight, Laura; Pallman, Philip; Jaki, Thomas; (2022) Point estimation for adaptive trial designs I: A methodological review. Statistics in Medicine 10.1002/sim.9605. (In press). Green open access

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Abstract

Recent FDA guidance on adaptive clinical trial designs defines bias as “a systematic tendency for the estimate of treatment effect to deviate from its true value,” and states that it is desirable to obtain and report estimates of treatment effects that reduce or remove this bias. The conventional end-of-trial point estimates of the treatment effects are prone to bias inmany adaptive designs, because they do not take into account the potential and realized trial adaptations. While much of the methodological developments on adaptive designs have tended to focus on control of type I error rates and power considerations, in contrast the question of biased estimation has received relatively less attention. This article is the first in a two-part series that studies the issue of potential bias in point estimation for adaptive trials. Part I provides a comprehensive review of the methods to remove or reduce the potential bias in point estimation of treatment effects for adaptive designs, while part II illustrates how to implement these in practice and proposes a set of guidelines for trial statisticians. The methods reviewed in this article can be broadly classified into unbiased and bias-reduced estimation, and we also provide a classification of estimators by the type of adaptive design. We compare the proposed methods, highlight available software and code, and discuss potential methodological gaps in the literature.

Type: Article
Title: Point estimation for adaptive trial designs I: A methodological review
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/sim.9605
Publisher version: https://doi.org/10.1002/sim.9605
Language: English
Additional information: Copyright © 2022 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: adaptive design, bias-correction, conditional bias, flexible design, point estimation
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10161218
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