Kahan, BC; Morris, TP; White, IR; Tweed, CD; Cro, S; Dahly, D; Pham, TM; ... Carpenter, JR; + view all Kahan, BC; Morris, TP; White, IR; Tweed, CD; Cro, S; Dahly, D; Pham, TM; Esmail, H; Babiker, A; Carpenter, JR; - view fewer (2020) Treatment estimands in clinical trials of patients hospitalised for COVID-19: ensuring trials ask the right questions. BMC Medicine , 18 (1) , Article 286. 10.1186/s12916-020-01737-0.

Preview

Text Kahan_Treatment estimands in clinical trials of patients hospitalised for COVID-19_VoR.pdf - Published Version Download (443kB) | Preview

Abstract

When designing a clinical trial, explicitly defining the treatment estimands of interest (that which is to be estimated) can help to clarify trial objectives and ensure the questions being addressed by the trial are clinically meaningful. There are several challenges when defining estimands. Here, we discuss a number of these in the context of trials of treatments for patients hospitalised with COVID-19 and make suggestions for how estimands should be defined for key outcomes. We suggest that treatment effects should usually be measured as differences in proportions (or risk or odds ratios) for outcomes such as death and requirement for ventilation, and differences in means for outcomes such as the number of days ventilated. We further recommend that truncation due to death should be handled differently depending on whether a patient- or resource-focused perspective is taken; for the former, a composite approach should be used, while for the latter, a while-alive approach is preferred. Finally, we suggest that discontinuation of randomised treatment should be handled from a treatment policy perspective, where non-adherence is ignored in the analysis (i.e. intention to treat).

Download activity - last month

Export as XMLCSVJSON

Download activity - last 12 months

Export as JSONXMLCSV

Downloads by country - last 12 months

Export as CSVXMLJSON

Archive Staff Only

View Item