Planning a future randomized clinical trial based on a network of relevant past trials

Trials
Georgia SalantiMatthias Egger

Abstract

The important role of network meta-analysis of randomized clinical trials in health technology assessment and guideline development is increasingly recognized. This approach has the potential to obtain conclusive results earlier than with new standalone trials or conventional, pairwise meta-analyses. Network meta-analyses can also be used to plan future trials. We introduce a four-step framework that aims to identify the optimal design for a new trial that will update the existing evidence while minimizing the required sample size. The new trial designed within this framework does not need to include all competing interventions and comparisons of interest and can contribute direct and indirect evidence to the updated network meta-analysis. We present the method by virtually planning a new trial to compare biologics in rheumatoid arthritis and a new trial to compare two drugs for relapsing-remitting multiple sclerosis. A trial design based on updating the evidence from a network meta-analysis of relevant previous trials may require a considerably smaller sample size to reach the same conclusion compared with a trial designed and analyzed in isolation. Challenges of the approach include the complexity of the methodology and the n...Continue Reading

References

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Citations

Nov 2, 2018·European Journal of Nutrition·Lukas SchwingshacklAnna Chaimani
Sep 17, 2020·Research Synthesis Methods·Annabel L Davies, Tobias Galla
Oct 18, 2020·BMJ : British Medical Journal·Huseyin NaciAndrea Cipriani
Oct 30, 2020·BMC Medical Ethics·Daria Kim, Joerg Hasford
Mar 7, 2021·BMC Psychiatry·Lisa Holper
Aug 26, 2021·Clinical Trials : Journal of the Society for Clinical Trials·Sarah M WeinsteinAlisa J Stephens-Shields
Oct 27, 2021·Multiple Sclerosis : Clinical and Laboratory Research·Louis Poncet-MegemontXavier Moisset

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