title: A general formulation for a one-sided group sequential design.
abstract: BACKGROUND
  A major contribution to the statistical literature on group sequential designs was provided by Pampallona and Tsiatis who developed closed form functions that can be used to iteratively calculate the boundary points of a family of popular group sequential designs. A related area of interest is the use of conditional probability calculations to make interim decisions in stochastic curtailment procedures.
  
  
  OBJECTIVE
  The purpose of the paper is to develop group sequential designs based on conditional probabilities, to compare our results to the general closed form family of designs developed by Pampallona and Tsiatis, and to relate these to commonly used stochastic curtailment procedures.
  
  
  METHODS
  The problem and its solution are formulated and derived mathematically. A graphical interpretation of the results provides the reader with an alternative mechanism to understand the results and their significance.
  
  
  RESULTS
  One-sided group sequential design boundary points, as closed form functions, are derived from conditional probability statements. These conditional probability statements can be interpreted as the probability, at the final analysis, of reversing the conclusion reached at an interim state. Under mild constraints, these boundary points are identical to the Pampallona and Tsiatis boundary points. At any interim stage when a boundary point is attained or surpassed we suggest a graphical approach to examine the conditional probability of reversing the interim decision at the final stage versus a range of possible parameter values. For stochastic curtailment procedures, we recommend relaxing (increasing) the conditional probability levels to at least 0.50 so that early stopping is at least as likely as for the O'Brien-Fleming procedure.
  
  
  CONCLUSIONS
  The results are limited to one-sided group sequential designs.
  
  
  CONCLUSIONS
  Conditional probabilities of reversing interim decisions provides a useful concept to develop group sequential designs and to evaluate stochastic curtailment procedures.
authors.affiliation: Cancer and Leukemia Group B Statistical Center, Duke University Medical Center, Box 2717, Durham, NC 27710, USA. moser004@mc.duke.edu
authors.forename: Barry K
authors.initials: BK
authors.lastname: Moser
authors.forename: Stephen L
authors.initials: SL
authors.lastname: George
mesh_terms: D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic / Q000379:methods / Q000706:statistics & numerical data*; D018572:Disease-Free Survival; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D016015:Logistic Models; D015233:Models, Statistical; D011336:Probability; D016016:Proportional Hazards Models; D012107:Research Design