Blinded continuous monitoring in clinical trials with recurrent event endpoints

In studies with recurrent event endpoints, misspecified assumptions of event rates or dispersion can lead to underpowered trials or overexposure of patients. Specification of overdispersion is often a particular problem as it is usually not reported in clinical trial publications. Changing event rates over the years have been described for some diseases, adding to the uncertainty in planning. To mitigate the risks of inadequate sample sizes, internal pilot study designs have been proposed with a preference for blinded sample size reestimation procedures, as they generally do not affect the type I error rate and maintain trial integrity. Blinded sample size reestimation procedures are available for trials with recurrent events as endpoints. However, the variance in the reestimated sample size can be considerable in particular with early sample size reviews. Motivated by a randomized controlled trial in paediatric multiple sclerosis, a rare neurological condition in children, we apply the concept of blinded continuous monitoring of information, which is known to reduce the variance in the resulting sample size. Assuming negative binomial distributions for the counts of recurrent relapses, we derive information criteria and propose blinded continuous monitoring procedures. The operating characteristics of these are assessed in Monte Carlo trial simulations demonstrating favourable properties with regard to type I error rate, power, and stopping time, ie, sample size.     

Inference and Decision Making for 21st-Century Drug Development and Approval

ABSTRACT

The cost and time of pharmaceutical drug development continue to grow at rates that many say are unsustainable. These trends have enormous impact on what treatments get to patients, when they get them and how they are used. The statistical framework for supporting decisions in regulated clinical development of new medicines has followed a traditional path of frequentist methodology. Trials using hypothesis tests of “no treatment effect” are done routinely, and the p-value < 0.05 is often the determinant of what constitutes a “successful” trial. Many drugs fail in clinical development, adding to the cost of new medicines, and some evidence points blame at the deficiencies of the frequentist paradigm. An unknown number effective medicines may have been abandoned because trials were declared “unsuccessful” due to a p-value exceeding 0.05. Recently, the Bayesian paradigm has shown utility in the clinical drug development process for its probability-based inference. We argue for a Bayesian approach that employs data from other trials as a “prior” for Phase 3 trials so that synthesized evidence across trials can be utilized to compute probability statements that are valuable for understanding the magnitude of treatment effect. Such a Bayesian paradigm provides a promising framework for improving statistical inference and regulatory decision making.     

Design selection for strong orthogonal arrays

Strong orthogonal arrays (SOAs) were recently introduced and studied as a class of space‐filling designs for computer experiments. An important problem that has not been addressed in the literature is that of design selection for such arrays. In this article, we conduct a systematic investigation into this problem, and we focus on the most useful SOA(n,m,4,2 + )s and SOA(n,m,4,2)s. This article first addresses the problem of design selection for SOAs of strength 2+ by examining their three‐dimensional projections. Both theoretical and computational results are presented. When SOAs of strength 2+ do not exist, we formulate a general framework for the selection of SOAs of strength 2 by looking at their two‐dimensional projections. The approach is fruitful, as it is applicable when SOAs of strength 2+ do not exist and it gives rise to them when they do. The Canadian Journal of Statistics 47: 302–314; 2019 © 2019 Statistical Society of Canada     

住宅小区景观的配套设计与绿化

当前，小区的景观配置及绿化已经成为人们选择住宅的重要条件之一。小区景观设计的细节往往是小区景观的配套设计与绿化成功的关键。住宅小区景观的配套设计与绿化是自然与人的完美协调与交融，是人的精神通过加工寄托于景物的一个过程。     

Modifications of sequential designs in bioequivalence trials

Bioequivalence (BE) studies are designed to show that two formulations of one drug are equivalent and they play an important role in drug development. When in a design stage, it is possible that there is a high degree of uncertainty on variability of the formulations and the actual performance of the test versus reference formulation. Therefore, an interim look may be desirable to stop the study if there is no chance of claiming BE at the end (futility), or claim BE if evidence is sufficient (efficacy), or adjust the sample size. Sequential design approaches specially for BE studies have been proposed previously in publications. We applied modification to the existing methods focusing on simplified multiplicity adjustment and futility stopping. We name our method modified sequential design for BE studies (MSDBE). Simulation results demonstrate comparable performance between MSDBE and the original published methods while MSDBE offers more transparency and better applicability. The R package MSDBE is available at https://sites.google.com/site/modsdbe/ . Copyright © 2015 John Wiley & Sons, Ltd.     

An Interview with Joyce Edward: Exemplary Clinician, Advocate, and Scholar

Over the years, noteworthy social workers have been interviewed for the Clinical Social Work Journal. This article features an interview with Joyce Edward who is recognized for her many extraordinary contributions to clinical social work. Joyce has co-written or co-edited three exceptional books for the social work clinician, she has been an esteemed teacher and a vocal activist for quality mental health care. In this interview Joyce reflects on family influences, her work as a social caseworker, the psychoanalytic luminaries with whom she trained, her concerns about the clinical education of today's social work students, and finally, her perspective on managed mental health care.     

三维实体设计与工程制图课程的改革

三维实体设计是工程设计的必然趋势,设计方法的变革导致企业对人才的新需求,也给传统的工程制图课程体系带来了巨大的冲击。改革与现代生产和人才需求不相适应的教学内容,建立以三维设计为主线,以培养创新思维和创新能力为目标的工程制图新体系,是工程制图课程改革的方向。     

基于WEB的远程教学管理软件分析与设计

本论文主要讨论了基于WEB远程教学管理软件的分析与设计。首先对远程教育与传统教育进行了比较研究,确定远程教育是现代教育发展的方向;其次对开发基于WEB远程教学管理软件进行了环境分析和需求分析;最后讨论了远程教学管理软件的实现,包括软件模块结构设计和网站的总体框架。     

工业设计专业数字化设计类课程体系建设的思考

针对数字化技术对工业设计的巨大影响 ,提出了工业设计专业数字化设计类课程体系的框架和对一些课程设置及教学方法的设想     

ALL-BIAS DESIGNS FOR POLYNOMIAL SPLINE REGRESSION MODELS

Polynomial spline regression models of low degree have proved useful in modeling responses from designed experiments in science and engineering when simple polynomial models are inadequate. Where there is uncertainty in the number and location of the knots, or breakpoints, of the spline, then designs that minimize the systematic errors resulting from model misspecification may be appropriate. This paper gives a method for constructing such all‐bias designs for a single variable spline when the distinct knots in the assumed and true models come from some specified set. A class of designs is defined in terms of the inter‐knot intervals and sufficient conditions are obtained for a design within this class to be all‐bias under linear, quadratic and cubic spline models. An example of the construction of all‐bias designs is given.