Adaptive trials, efficiency, and ethics

Excerpt

Adaptive clinical trials employ a class of study designs that take advantage of the accumulating state of evidence in a trial to make midstream modifications to the trial’s structure or parameters. Under the right conditions, adaptive trials can be more efficient than traditional, non-adaptive designs. For example, they can allow several hypotheses to be tested using the same infrastructure, or fewer participants to be enrolled to achieve the same level of statistical power. But what are some of these ‘right’ conditions that make adaptive trials more efficient? This is the question asked by Wason et al. [1], who are concerned that the methodological literature may have overstated some of the advantages of adaptive designs, and overlooked some of the disadvantages. …