TY - JOUR
T1 - A conceptual model for the development process of confirmatory adaptive clinical trials within an emergency research network
AU - Mawocha, Samkeliso C.
AU - Fetters, Michael D.
AU - Legocki, Laurie J.
AU - Guetterman, Timothy C.
AU - Frederiksen, Shirley
AU - Barsan, William G.
AU - Lewis, Roger J.
AU - Berry, Donald A.
AU - Meurer, William J.
N1 - Publisher Copyright:
© The Author(s) 2017.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Background: Adaptive clinical trials use accumulating data from enrolled subjects to alter trial conduct in pre-specified ways based on quantitative decision rules. In this research, we sought to characterize the perspectives of key stakeholders during the development process of confirmatory-phase adaptive clinical trials within an emergency clinical trials network and to build a model to guide future development of adaptive clinical trials. Methods: We used an ethnographic, qualitative approach to evaluate key stakeholders' views about the adaptive clinical trial development process. Stakeholders participated in a series of multidisciplinary meetings during the development of five adaptive clinical trials and completed a Strengths-Weaknesses-Opportunities-Threats questionnaire. In the analysis, we elucidated overarching themes across the stakeholders' responses to develop a conceptual model. Results: Four major overarching themes emerged during the analysis of stakeholders' responses to questioning: the perceived statistical complexity of adaptive clinical trials and the roles of collaboration, communication, and time during the development process. Frequent and open communication and collaboration were viewed by stakeholders as critical during the development process, as were the careful management of time and logistical issues related to the complexity of planning adaptive clinical trials. Conclusion: The Adaptive Design Development Model illustrates how statistical complexity, time, communication, and collaboration are moderating factors in the adaptive design development process. The intensity and iterative nature of this process underscores the need for funding mechanisms for the development of novel trial proposals in academic settings.
AB - Background: Adaptive clinical trials use accumulating data from enrolled subjects to alter trial conduct in pre-specified ways based on quantitative decision rules. In this research, we sought to characterize the perspectives of key stakeholders during the development process of confirmatory-phase adaptive clinical trials within an emergency clinical trials network and to build a model to guide future development of adaptive clinical trials. Methods: We used an ethnographic, qualitative approach to evaluate key stakeholders' views about the adaptive clinical trial development process. Stakeholders participated in a series of multidisciplinary meetings during the development of five adaptive clinical trials and completed a Strengths-Weaknesses-Opportunities-Threats questionnaire. In the analysis, we elucidated overarching themes across the stakeholders' responses to develop a conceptual model. Results: Four major overarching themes emerged during the analysis of stakeholders' responses to questioning: the perceived statistical complexity of adaptive clinical trials and the roles of collaboration, communication, and time during the development process. Frequent and open communication and collaboration were viewed by stakeholders as critical during the development process, as were the careful management of time and logistical issues related to the complexity of planning adaptive clinical trials. Conclusion: The Adaptive Design Development Model illustrates how statistical complexity, time, communication, and collaboration are moderating factors in the adaptive design development process. The intensity and iterative nature of this process underscores the need for funding mechanisms for the development of novel trial proposals in academic settings.
KW - Adaptive clinical trials
KW - Strength-Weaknesses-Opportunities-Threats
KW - confirmatory-phase clinical trials
KW - mixed methods
KW - neurology clinical trials
KW - qualitative research
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U2 - 10.1177/1740774516688900
DO - 10.1177/1740774516688900
M3 - Article
C2 - 28135827
AN - SCOPUS:85019674865
SN - 1740-7745
VL - 14
SP - 246
EP - 254
JO - Clinical Trials
JF - Clinical Trials
IS - 3
ER -