Optimal placebo-treatment comparisons in trials with an incomplete within-subject design and heterogeneous costs and variances.

The aim of a clinical trial is to compare placebo to one or more treatments. The within-subject design is known to be more efficient than the between-subject design. However, in some trials that implement a within-subject design it is not possible to evaluate the placebo and all treatments within ea...

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Main Author: Mirjam Moerbeek
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0283382
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author Mirjam Moerbeek
author_facet Mirjam Moerbeek
author_sort Mirjam Moerbeek
collection DOAJ
description The aim of a clinical trial is to compare placebo to one or more treatments. The within-subject design is known to be more efficient than the between-subject design. However, in some trials that implement a within-subject design it is not possible to evaluate the placebo and all treatments within each subject. The design then becomes an incomplete within-subject design. An important question is how many subjects should be allocated to each combination of placebo and treatments. This paper studies optimal allocations of subjects in trials with a placebo and two treatments under heterogenous costs and variances. Two optimality criteria that consider the placebo-treatment contrasts simultaneously are considered, and the design is derived under a budgetary constraint. More subjects are allocated to those combinations with higher variances and lower costs. The optimal allocation is compared to the uniform allocation, which allocates equal number of subjects to each placebo and treatment combination, and to the complete within-subject design, where placebo and all treatments are available in each subject. The methodology is illustrated on the basis of an example on consultation time in primary care. A Shiny app is available to facilitate use of the methodology.
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spelling doaj.art-5afc73e2282d4a62bc25ef39820cfdbc2023-05-10T05:31:58ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01184e028338210.1371/journal.pone.0283382Optimal placebo-treatment comparisons in trials with an incomplete within-subject design and heterogeneous costs and variances.Mirjam MoerbeekThe aim of a clinical trial is to compare placebo to one or more treatments. The within-subject design is known to be more efficient than the between-subject design. However, in some trials that implement a within-subject design it is not possible to evaluate the placebo and all treatments within each subject. The design then becomes an incomplete within-subject design. An important question is how many subjects should be allocated to each combination of placebo and treatments. This paper studies optimal allocations of subjects in trials with a placebo and two treatments under heterogenous costs and variances. Two optimality criteria that consider the placebo-treatment contrasts simultaneously are considered, and the design is derived under a budgetary constraint. More subjects are allocated to those combinations with higher variances and lower costs. The optimal allocation is compared to the uniform allocation, which allocates equal number of subjects to each placebo and treatment combination, and to the complete within-subject design, where placebo and all treatments are available in each subject. The methodology is illustrated on the basis of an example on consultation time in primary care. A Shiny app is available to facilitate use of the methodology.https://doi.org/10.1371/journal.pone.0283382
spellingShingle Mirjam Moerbeek
Optimal placebo-treatment comparisons in trials with an incomplete within-subject design and heterogeneous costs and variances.
PLoS ONE
title Optimal placebo-treatment comparisons in trials with an incomplete within-subject design and heterogeneous costs and variances.
title_full Optimal placebo-treatment comparisons in trials with an incomplete within-subject design and heterogeneous costs and variances.
title_fullStr Optimal placebo-treatment comparisons in trials with an incomplete within-subject design and heterogeneous costs and variances.
title_full_unstemmed Optimal placebo-treatment comparisons in trials with an incomplete within-subject design and heterogeneous costs and variances.
title_short Optimal placebo-treatment comparisons in trials with an incomplete within-subject design and heterogeneous costs and variances.
title_sort optimal placebo treatment comparisons in trials with an incomplete within subject design and heterogeneous costs and variances
url https://doi.org/10.1371/journal.pone.0283382
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