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Common Probability Models
  • Defining the study structure
    • One arm trial: Historical or matched controls
      • comparison to absolute reference
    • Two arm trial: Placebo or Active controls
      • comparison between arms
    • Multiple arm trial: Several treatments or doses
      • global tests vs pairwise comparisons
    • Regression trial: Continuous dose response
      • test slope parameters


    • Also need to consider randomization ratio across treatment arms (or distribution of dose levels)
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Probability Model: Comparison Groups
  • No comparison group
    • Appropriate when an absolute criterion for treatment effect exists


    • Single arm clinical trial
      • Cohort design


    • (Rarely do such absolute criteria exist. Instead, we are really invoking the use of results from previous investigations.)
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Probability Model: Comparison Groups
  • Historical controls
    • Single arm clinical trial


    • Compare results to
      • Absolute criterion derived from historical trials
      • Sample from historical clinical trial (better)
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Probability Model: Comparison Groups
  • Comment re use of single arm trials


    • “There are only two types of researchers:
      • those with a lot of enthusiasm and no controls, and
      • those with a lot of controls and no enthusiasm.”
    •                                               (unknown)
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Probability Model: Comparison Groups
  • Internal controls


    • Each subject serves as his/her own control
      • Different treatments at different times
      • Different treatments for different parts of body
        • eye diseases, skin diseases
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Probability Model: Comparison Groups
  • Concurrent control group


    • Two or more treatment arms
      • Placebo or standard therapy
      • Active treatments
        • Sometimes consider equivalence
      • Multiple levels of same treatment
        • Stronger evidence sometimes obtained from dose-response
        • Identifying optimal dose