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1
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2
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- Defining the study structure
- One arm trial: Historical or matched controls
- comparison to absolute reference
- Two arm trial: Placebo or Active controls
- Multiple arm trial: Several treatments or doses
- global tests vs pairwise comparisons
- Regression trial: Continuous dose response
- Also need to consider randomization ratio across treatment arms (or
distribution of dose levels)
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3
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- No comparison group
- Appropriate when an absolute criterion for treatment effect exists
- Single arm clinical trial
- (Rarely do such absolute criteria exist. Instead, we are really
invoking the use of results from previous investigations.)
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4
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- 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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5
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- 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.”
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(unknown)
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6
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- 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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7
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- 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
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