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Michael K Smith

Publications and source records attributed to Michael K Smith.

3 recordsLinked to original sources

A Bayesian design and analysis for dose-response using informative prior information.

We wish to use prior information on an existing drug in the design and analysis of a dose-response study for a new drug candidate within the same pharmacological class. Using the Bayesian methodology, this prior information can be used quantitatively and the randomization can be weighted in favor of the new compound, where there is less information. An Emax model is used to describe the dose-response of the existing drug. The estimates from this model are used to provide informative prior information used for the design and analysis of the new study to establish the relative potency between the new compound and the existing drug therapy. The assumption is made that the data from previous trials and the new study are exchangeable. The impact of departures from this assumption can be quantified through simulations and by assessing the operating characteristics of various scenarios. Simulations show that relatively modest sample sizes can yield informative results about the magnitude of the relative potency using this approach. The operating characteristics are good when assessing model estimates against clinically important changes in relative potency.

Algorithms↗

Implementation of a Bayesian adaptive design in a proof of concept study.

With increased costs of drug development the need for efficient studies has become critical. A key decision point on the development pathway has become the proof of concept study. These studies must provide clear information to the project teams to enable decision making about further developing a drug candidate but also to gain evidence that any effect size is sufficient to warrant this development given the current market environment. Our case study outlines one such proof of concept trial where a new candidate therapy for neuropathic pain was investigated to assess dose-response and to evaluate the magnitude of its effect compared to placebo. A Normal Dynamic Linear Model was used to estimate the dose-response--enforcing some smoothness in the dose-response, but allowing for the fact that the dose-response may be non-monotonic. A pragmatic, parallel group study design was used with interim analyses scheduled to allow the sponsor to drop ineffective doses or to stop the study. Simulations were performed to assess the operating characteristics of the study design. The study results are presented. Significant cost savings were made when it transpired that the new candidate drug did not show superior efficacy when compared placebo and the study was stopped.

Bayes Theorem↗