How do multi-stage, multi-arm trials compare to the traditional two-arm parallel group design--a reanalysis of 4 trials.
BACKGROUND
To speed up the evaluation of new therapies, the multi-arm, multi-stage trial design was suggested previously by the authors.


METHODS
In this paper, we evaluate the performance of the two-stage, multi-arm design using four cancer trials conducted at the MRC CTU. The performance of the design at fictitious interim analyses is assessed using a conditional bootstrap approach.


RESULTS
Two main aims are addressed: the error rate of correctly carrying on/stopping the trial at an interim analysis as well as quantifying the gains in terms of resources by employing this design. Furthermore, we make suggestions for the best timing of this interim analysis.


CONCLUSIONS
Multi-arm, multi-stage trials are an effective way of speeding up the therapy evaluation process. The design performs well in terms of the type I and II error rates.
Department of Biostatistics, Institute of Psychiatry, King's College London, London, UK. sophie@fm-sbarthel.de
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FM
Barthel
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MK
Parmar
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P
Royston
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018572:Disease-Free Survival; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012107:Research Design; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
D000970:Antineoplastic Agents