title: A Bayesian predictive strategy for an adaptive two-stage design in phase II clinical trials.
abstract: Phase II clinical trials are typically designed as two-stage studies, in order to ensure early termination of the trial if the interim results show that the treatment is ineffective. Most of two-stage designs, developed under both a frequentist and a Bayesian framework, select the second stage sample size before observing the first stage data. This may cause some paradoxical situations during the practical carrying out of the trial. To avoid these potential problems, we suggest a Bayesian predictive strategy to derive an adaptive two-stage design, where the second stage sample size is not selected in advance, but depends on the first stage result. The criterion we propose is based on a modification of a Bayesian predictive design recently presented in the literature (see (Statist. Med. 2008; 27:1199-1224)). The distinction between analysis and design priors is essential for the practical implementation of the procedure: some guidelines for choosing these prior distributions are discussed and their impact on the required sample size is examined.
authors.affiliation: Department of Statistics, Probability and Applied Statistics, Sapienza University of Rome, Rome, Italy. valeria.sambucini@uniroma1.it
authors.forename: Valeria
authors.initials: V
authors.lastname: Sambucini
mesh_terms: D001499:Bayes Theorem; D017322:Clinical Trials, Phase II as Topic / Q000379:methods*; D015340:Epidemiologic Research Design; D005544:Forecasting / Q000379:methods; D006801:Humans; D018401:Sample Size