An overview of the adaptive designs accelerating promising trials into treatments (ADAPT-IT) project.

Abstract:

:Randomized clinical trials, which aim to determine the efficacy and safety of drugs and medical devices, are a complex enterprise with myriad challenges, stakeholders, and traditions. Although the primary goal is scientific discovery, clinical trials must also fulfill regulatory, clinical, and ethical requirements. Innovations in clinical trials methodology have the potential to improve the quality of knowledge gained from trials, the protection of human subjects, and the efficiency of clinical research. Adaptive clinical trial methods represent a broad category of innovations intended to address a variety of long-standing challenges faced by investigators, such as sensitivity to previous assumptions and delayed identification of ineffective treatments. The implementation of adaptive clinical trial methods, however, requires greater planning and simulation compared with a more traditional design, along with more advanced administrative infrastructure for trial execution. The value of adaptive clinical trial methods in exploratory phase (phase 2) clinical research is generally well accepted, but the potential value and challenges of applying adaptive clinical trial methods in large confirmatory phase clinical trials are relatively unexplored, particularly in the academic setting. In the Adaptive Designs Accelerating Promising Trials Into Treatments (ADAPT-IT) project, a multidisciplinary team is studying how adaptive clinical trial methods could be implemented in planning actual confirmatory phase trials in an established, National Institutes of Health-funded clinical trials network. The overarching objectives of ADAPT-IT are to identify and quantitatively characterize the adaptive clinical trial methods of greatest potential value in confirmatory phase clinical trials and to elicit and understand the enthusiasms and concerns of key stakeholders that influence their willingness to try these innovative strategies.

journal_name

Ann Emerg Med

authors

Meurer WJ,Lewis RJ,Tagle D,Fetters MD,Legocki L,Berry S,Connor J,Durkalski V,Elm J,Zhao W,Frederiksen S,Silbergleit R,Palesch Y,Berry DA,Barsan WG

doi

10.1016/j.annemergmed.2012.01.020

subject

Has Abstract

pub_date

2012-10-01 00:00:00

pages

451-7

issue

4

eissn

0196-0644

issn

1097-6760

pii

S0196-0644(12)00110-2

journal_volume

60

pub_type

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