Statistical design and analysis of response adaptive clinical trials

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The use of randomization is essential in clinical trials because it masks the treatment identity, promotes the similarity of treatment groups and validates the use of statistics. However in desperate medical situations, the gold standard of balanced randomization favors the collective ethics (i.e., the benefits to the patients after the trial) but hinders the individual ethics (i.e., the paramount interests of the patients in the trial), and hence becomes ethically infeasible. This conflict is alleviated with the use of response adaptive randomization, the goal of which is to evaluate and utilize the accumulating information so as to improve the efficiency and ethics of the trial without undermining the validity and integrity of the clinical research. Most patients in the trial are expected to receive the potentially superior treatment without sacrifice to the collective ethics. This is a very important issue because in the 21st century, there is a greater demand of personal care in medical research.