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首页> 外文期刊>BMJ Open >Meeting the demand for more sophisticated study designs. A proposal for a new type of clinical trial: the hybrid design
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Meeting the demand for more sophisticated study designs. A proposal for a new type of clinical trial: the hybrid design

机译:满足对更复杂的研究设计的需求。新型临床试验的建议:混合设计

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Background Treatment effect is traditionally assessed through either superiority or non-inferiority clinical trials. Investigators may find that because of safety concerns and/or wide variability across strata of the superiority margin of active controls over placebo, neither a superiority nor a non-inferiority trial design is ethical or practical in some disease populations. Prior knowledge may allow and drive study designers to consider more sophisticated designs for a clinical trial. Design In this paper, the authors propose hybrid designs which may combine a superiority design in one subgroup with a non-inferiority design in another subgroup or combine designs with different control regimens in different subgroups in one trial when a uniform design is unethical or impractical. The authors show how the hybrid design can be planned and how inferences can be made. Through two examples, the authors illustrate the scenarios where hybrid designs are useful while the conventional designs are not preferable. Conclusion The hybrid design is a useful alternative to current superiority and non-inferiority designs.
机译:背景技术治疗效果传统上是通过优越性或非劣势性临床试验评估的。研究者可能会发现,由于安全方面的考虑和/或主动控制优于安慰剂的优势差异在各个层次上存在很大差异,因此在某些疾病人群中,优越性或非劣效性试验设计均不符合道德或实际要求。先前的知识可能允许并推动研究设计者考虑将更复杂的设计用于临床试验。设计在本文中,作者提出了一种混合设计,当一个统一的设计不道德或不切实际时,可以在一个试验中将一个子组中的优势设计与另一子组中的非劣等设计相结合,或在不同的子组中将具有不同控制方案的设计相结合。作者展示了如何设计混合设计以及如何进行推理。作者通过两个示例说明了混合设计有用而传统设计不理想的情况。结论混合设计是当前优等设计的有用替代方案。

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