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平台试验中治疗效果的适应性与异质性——两项方法学研究的方案

Adaptations and Heterogeneity of Treatment Effects in Platform Trials-Protocol for Two Methodological Studies.

作者信息

Meyhoff Tine Sylvest, Jensen Aksel Karl Georg, Perner Anders, Goligher Ewan C, Campbell Marion K, Møller Morten Hylander, Granholm Anders

机构信息

Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

出版信息

Acta Anaesthesiol Scand. 2025 Jul;69(6):e70044. doi: 10.1111/aas.70044.

Abstract

BACKGROUND

Adaptive platform trials bring opportunities for improved infrastructure and effective advancement in medical care but are methodologically complex. Assessment of heterogeneity of treatment effects (HTE) according to participant characteristics and adaptations, including adaptive stopping, are important methodological features in these trials, which may be approached in multiple ways. We aim to characterise the assessment of HTE and use of adaptations, including their key methodological features, in adaptive platform trials.

METHODS

This protocol outlines two methodological studies, which will be based on a common, systematic literature search and data extraction. We will include adaptive platform trials conducted from 2005 onwards. Screening and data extraction will be performed independently and in duplicate. In Study I, we will assess methods used to evaluate HTE, and in Study II, we will assess adaptations and stopping rules in the included trials.

DISCUSSION

The two proposed methodological studies will provide an overview of important methodological features regarding the assessment of HTE and adaptations used in adaptive platform trials. Better knowledge of available methods to assess these features can improve the conditions for designing adaptive platform trials and identify areas for further development.

摘要

背景

适应性平台试验为改善医疗基础设施和有效推进医疗护理带来了机遇,但在方法上较为复杂。根据参与者特征和适应性对治疗效果异质性(HTE)进行评估,包括适应性停止,是这些试验重要的方法学特征,对此可采用多种方法。我们旨在描述适应性平台试验中HTE评估及适应性应用情况,包括其关键方法学特征。

方法

本方案概述了两项方法学研究,这两项研究将基于共同的系统文献检索和数据提取。我们将纳入2005年起开展的适应性平台试验。筛选和数据提取将独立进行且重复两次。在研究I中,我们将评估用于评估HTE的方法,在研究II中,我们将评估纳入试验中的适应性和停止规则。

讨论

两项拟开展的方法学研究将概述适应性平台试验中HTE评估及所采用适应性方面的重要方法学特征。更好地了解评估这些特征的可用方法可改善适应性平台试验的设计条件,并确定进一步发展的领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f0a/12056685/a16e2138d495/AAS-69-0-g001.jpg

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