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10.1002/sim.6443

http://scihub22266oqcxt.onion/10.1002/sim.6443
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C4390488!4390488!25626676
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suck abstract from ncbi


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pmid25626676      Stat+Med 2015 ; 34 (10): 1721-32
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  • A Bayesian Dose-finding Design for Phase I/II Clinical Trials with Non-ignorable Dropouts #MMPMID25626676
  • Guo B; Yuan Y
  • Stat Med 2015[May]; 34 (10): 1721-32 PMID25626676show ga
  • Phase I/II trials utilize both toxicity and efficacy data to achieve efficient dose finding. However, due to the requirement of assessing efficacy outcome, which often takes a long period of time to be evaluated, the duration of phase I/II trials is often longer than that of the conventional dose-finding trials. As a result, phase I/II trials are susceptible to the missing data problem caused by patient dropout, and the missing efficacy outcomes are often non-ignorable in the sense that patients who do not experience treatment efficacy are more likely to drop out of the trial. We propose a Bayesian phase I/II trial design to accommodate non-ignorable dropouts. We treat toxicity as a binary outcome and efficacy as a time-to-event outcome. We model the marginal distribution of toxicity using a logistic regression and jointly model the times to efficacy and dropout using proportional hazard models to adjust for non-ignorable dropouts. The correlation between times to efficacy and dropout is modeled using a shared frailty. We propose a two-stage dose-finding algorithm to adaptively assign patients to desirable doses. Simulation studies show that the proposed design has desirable operating characteristics. Our design selects the target dose with a high probability and assigns most patients to the target dose.
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