Quantifying and documenting prior beliefs in clinical trials.
Collecting and documenting subjective prior beliefs from knowledgeable clinicians about the potential results of a clinical trial has many advantages. Two large trials of prophylactic treatments in an HIV-positive population are used as examples. The trials recruited patients of primary care physicians and compared treatments which were in use in clinical practice. Opinions about these trials were elicited from 58 practising HIV clinicians. It is shown how the documented opinions can be used to augment the monitoring process; the prior opinions are updated with interim data using approximate Bayesian methods to give posterior opinions incorporating interim results. These posterior opinions can be used by the monitoring board to anticipate the clinicians' reaction to the results. Eliciting prior beliefs is also ethically important for documenting the nature of the uncertainty or equipoise. Important information is provided for the informed consent process and Institutional Review Board (IRB).
Chaloner
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School of Statistics, University of Minnesota, 313 Ford Hall, 224 Church Street S.E., Minneapolis, MN 55455, USA. kathryn@stat.umn.edu
Rhame
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D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000517:prevention & control; D000890:Anti-Infective Agents / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D053626:Atovaquone; D001291:Attitude of Health Personnel; D001499:Bayes Theorem; D002986:Clinical Trials as Topic; D003622:Dapsone / Q000008:administration & dosage; D004992:Ethics, Medical; D015658:HIV Infections / Q000150:complications; D006801:Humans; D009285:Naphthoquinones / Q000008:administration & dosage; D010820:Physicians / Q000523:psychology*; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D018401:Sample Size; D011795:Surveys and Questionnaires; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage
D000890:Anti-Infective Agents; D000935:Antifungal Agents; D009285:Naphthoquinones; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003622:Dapsone; D053626:Atovaquone