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Combining factorial and multi-arm multi-stage platform designs to evaluate multiple interventions efficiently

White, Ian; Choodari-Oskooei, Babak; Sydes, Matthew R; Kahan, Brennan; McCabe, Leanne; Turkova, Anna; Esmail, Hanif; ... Ford, Deborah; + view all (2022) Combining factorial and multi-arm multi-stage platform designs to evaluate multiple interventions efficiently. Clinical Trials 10.1177/17407745221093577. (In press). Green open access

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Abstract

BACKGROUND: Factorial-MAMS design platform designs have many advantages, but the practical advantages and disadvantages of combining the two designs have not been explored. METHODS: We propose practical methods for a combined design within the platform trial paradigm where some interventions are not expected to interact and could be given together. RESULTS: We describe the combined design and suggest diagrams that can be used to represent it. Many properties are common both to standard factorial designs, including the need to consider interactions between interventions and the impact of intervention efficacy on power of other comparisons, and to standard multi-arm multi-stage designs, including the need to pre-specify procedures for starting and stopping intervention comparisons. We also identify some specific features of the factorial-MAMS design: timing of interim and final analyses should be determined by calendar time or total observed events; some non-factorial modifications may be useful; eligibility criteria should be broad enough to include any patient eligible for any part of the randomisation; stratified randomisation may conveniently be performed sequentially; and analysis requires special care to use only concurrent controls. CONCLUSION: A combined factorial-MAMS design can combine the efficiencies of factorial trials and multi-arm multi-stage platform trials. It allows us to address multiple research questions under one protocol and to test multiple new treatment options, which is particularly important when facing a new emergent infection such as COVID-19.

Type: Article
Title: Combining factorial and multi-arm multi-stage platform designs to evaluate multiple interventions efficiently
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/17407745221093577
Publisher version: https://doi.org/10.1177%2F17407745221093577
Language: English
Additional information: © 2022 by The Society for Clinical Trials. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/).
Keywords: Platform trials, adaptive trial designs, factorial trial, multi-arm multi-stage
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10148958
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