Bayesian adaptive design for device surveillance.

Bayesian adaptive design for device surveillance.
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DOI:
10.1177/1740774512464725
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发表时间:
2013-02
期刊:
Clinical trials (London, England)
影响因子:
--
通讯作者:
Lystig TC
Lystig TC
中科院分区:
其他
文献类型:
--
作者:
Murray TA;Carlin BP;Lystig TC

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上市后的设备监测研究通常有重要的主要目标,与以一定的精度估计未来时间T的生存函数有关。本文介绍了一种用于设备监视的贝叶斯自适应设计的细节和各种工作特性,以及一种估计将提供所需功率的样本量向量(由最大样本量和预先设置的临时观察次数确定)的方法。我们采用贝叶斯自适应框架,该框架承认这样一个事实,即参加研究的人会随着时间的推移报告他们的结果,而不是一下子全部报告。在每一次中期考察中,我们都会评估我们是否期望仅在当前群体中实现我们的目标,或者即使在最大样本量的情况下,实现这样的目标也是极不可能的。我们的贝叶斯自适应设计可以在许多情况下优于FDA指南文件目前推荐的两种非自适应频率法。我们的方法的性能可能会对模型错误指定和试验注册率的变化敏感。拟议的设计为医疗器械的上市后监督提供了一个更有效的框架。
Post-market device surveillance studies often have important primary objectives tied to estimating a survival function at some future time T with a certain amount of precision. This paper presents the details and various operating characteristics of a Bayesian adaptive design for device surveillance, as well as a method for estimating a sample size vector (determined by the maximum sample size and a pre-set number of interim looks) that will deliver the desired power. We adopt a Bayesian adaptive framework which recognizes the fact that persons enrolled in a study report their results over time, not all at once. At each interim look we assess whether we expect to achieve our goals with only the current group, or whether the achievement of such goals is extremely unlikely even for the maximum sample size. Our Bayesian adaptive design can outperform two non-adaptive frequentist methods currently recommended by FDA guidance documents in many settings. Our method's performance can be sensitive to model misspecification and changes in the trial's enrollment rate. The proposed design provides a more efficient framework for conducting postmarket surveillance of medical devices.
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