Minimal sufficient balance randomization for sequential randomized controlled trial designs: results from the ESCAPE trial

Abstract Background We describe the implementation of minimal sufficient balance randomization, a covariate-adaptive randomization technique, used for the “Endovascular treatment for Small Core and Anterior circulation Proximal occlusion with Emphasis on minimizing CT to recanalization times” (ESCAP...

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Main Authors: Tolulope T. Sajobi, Gurbakhshash Singh, Mark W. Lowerison, Jordan Engbers, Bijoy K. Menon, Andrew M. Demchuk, Mayank Goyal, Michael D. Hill
Format: Article
Language:English
Published: BMC 2017-11-01
Series:Trials
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13063-017-2264-1
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author Tolulope T. Sajobi
Gurbakhshash Singh
Mark W. Lowerison
Jordan Engbers
Bijoy K. Menon
Andrew M. Demchuk
Mayank Goyal
Michael D. Hill
author_facet Tolulope T. Sajobi
Gurbakhshash Singh
Mark W. Lowerison
Jordan Engbers
Bijoy K. Menon
Andrew M. Demchuk
Mayank Goyal
Michael D. Hill
author_sort Tolulope T. Sajobi
collection DOAJ
description Abstract Background We describe the implementation of minimal sufficient balance randomization, a covariate-adaptive randomization technique, used for the “Endovascular treatment for Small Core and Anterior circulation Proximal occlusion with Emphasis on minimizing CT to recanalization times” (ESCAPE) trial. Methods The ESCAPE trial is a prospective, multicenter, randomized clinical trial that enrolled subjects with the following main inclusion criteria: less than 12 h from symptom onset, age 18 years or older, baseline NIHSS score > 5, ASPECTS score > 5 and computed tomography angiography (CTA) evidence of carotid T/L or M1-segment middle cerebral artery (MCA) occlusion, and at least moderate collaterals by CTA. Patients were randomized using a real-time, dynamic, Internet-based, minimal sufficient balance randomization method that balanced the study arms with respect to baseline covariates including age, sex, baseline NIHSS score, site of arterial occlusion, baseline ASPECTS score and treatment with intravenously administered alteplase. Results Permutation-based tests of group differences confirmed group balance across several baseline covariates including sex (p = 1.00), baseline NIHSS score (p = 0.95), site of arterial occlusion (p = 1.00), baseline ASPECTS score (p = 0.28), treatment with intravenously administered alteplase (p = 0.31), and age (p = 0.67). Conclusion Results from the ESCAPE trial demonstrate the feasibility and the benefit of this covariate adaptive randomization scheme in small-sample trials and for data monitoring endeavors. Trial registration ESCAPE trial – NCT01778335 – at www.clinicaltrials.gov . Registered on 29 January 2013.
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spelling doaj.art-d39e30e7e4dd4f7eae3b4c580eb5d45e2022-12-21T19:27:55ZengBMCTrials1745-62152017-11-011811610.1186/s13063-017-2264-1Minimal sufficient balance randomization for sequential randomized controlled trial designs: results from the ESCAPE trialTolulope T. Sajobi0Gurbakhshash Singh1Mark W. Lowerison2Jordan Engbers3Bijoy K. Menon4Andrew M. Demchuk5Mayank Goyal6Michael D. Hill7Department of Community Health Sciences and O’Brien Institute for Public Health, Cumming School of Medicine, University of CalgaryDepartment of Community Health Sciences and O’Brien Institute for Public Health, Cumming School of Medicine, University of CalgaryDepartment of Community Health Sciences and O’Brien Institute for Public Health, Cumming School of Medicine, University of CalgaryClinical Research Unit, Cumming School of Medicine, University of CalgaryDepartment of Community Health Sciences and O’Brien Institute for Public Health, Cumming School of Medicine, University of CalgaryDepartment of Clinical Neurosciences, Cumming School of Medicine, University of CalgaryDepartment of Clinical Neurosciences, Cumming School of Medicine, University of CalgaryDepartment of Community Health Sciences and O’Brien Institute for Public Health, Cumming School of Medicine, University of CalgaryAbstract Background We describe the implementation of minimal sufficient balance randomization, a covariate-adaptive randomization technique, used for the “Endovascular treatment for Small Core and Anterior circulation Proximal occlusion with Emphasis on minimizing CT to recanalization times” (ESCAPE) trial. Methods The ESCAPE trial is a prospective, multicenter, randomized clinical trial that enrolled subjects with the following main inclusion criteria: less than 12 h from symptom onset, age 18 years or older, baseline NIHSS score > 5, ASPECTS score > 5 and computed tomography angiography (CTA) evidence of carotid T/L or M1-segment middle cerebral artery (MCA) occlusion, and at least moderate collaterals by CTA. Patients were randomized using a real-time, dynamic, Internet-based, minimal sufficient balance randomization method that balanced the study arms with respect to baseline covariates including age, sex, baseline NIHSS score, site of arterial occlusion, baseline ASPECTS score and treatment with intravenously administered alteplase. Results Permutation-based tests of group differences confirmed group balance across several baseline covariates including sex (p = 1.00), baseline NIHSS score (p = 0.95), site of arterial occlusion (p = 1.00), baseline ASPECTS score (p = 0.28), treatment with intravenously administered alteplase (p = 0.31), and age (p = 0.67). Conclusion Results from the ESCAPE trial demonstrate the feasibility and the benefit of this covariate adaptive randomization scheme in small-sample trials and for data monitoring endeavors. Trial registration ESCAPE trial – NCT01778335 – at www.clinicaltrials.gov . Registered on 29 January 2013.http://link.springer.com/article/10.1186/s13063-017-2264-1Minimal sufficient balanceRandomizationStroke trialEndovascular therapyData monitoring
spellingShingle Tolulope T. Sajobi
Gurbakhshash Singh
Mark W. Lowerison
Jordan Engbers
Bijoy K. Menon
Andrew M. Demchuk
Mayank Goyal
Michael D. Hill
Minimal sufficient balance randomization for sequential randomized controlled trial designs: results from the ESCAPE trial
Trials
Minimal sufficient balance
Randomization
Stroke trial
Endovascular therapy
Data monitoring
title Minimal sufficient balance randomization for sequential randomized controlled trial designs: results from the ESCAPE trial
title_full Minimal sufficient balance randomization for sequential randomized controlled trial designs: results from the ESCAPE trial
title_fullStr Minimal sufficient balance randomization for sequential randomized controlled trial designs: results from the ESCAPE trial
title_full_unstemmed Minimal sufficient balance randomization for sequential randomized controlled trial designs: results from the ESCAPE trial
title_short Minimal sufficient balance randomization for sequential randomized controlled trial designs: results from the ESCAPE trial
title_sort minimal sufficient balance randomization for sequential randomized controlled trial designs results from the escape trial
topic Minimal sufficient balance
Randomization
Stroke trial
Endovascular therapy
Data monitoring
url http://link.springer.com/article/10.1186/s13063-017-2264-1
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