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Design of multi-arm multi-stage trials

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In many disease areas there are multiple experimental treatments awaiting testing in clinical trials. Multi-arm trials provide large gains in efficiency over separate randomised trials of each treatment by using a shared control group. Further increases in efficiency can be obtained by introducing interim analyses at which modifications can be made to the proportion of patients allocated to each treatment. Such a design is called a multi-arm multi-stage (MAMS) trial. In this talk I will discuss and compare three classes of MAMS designs that can be used to increase efficiency and ethical properties of a multi-arm trial: group-sequential designs, drop-the-loser designs and adaptive randomisation. I will also discuss some statistical issues that are common to all three.

This talk is part of the Cambridge Statistics Discussion Group (CSDG) series.

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