
doi: 10.2307/2533975
pmid: 9192462
We describe a family of random walk rules for the sequential allocation of dose levels to patients in a dose-response study, or phase I clinical trial. Patients are sequentially assigned the next higher, same, or next lower dose level according to some probability distribution, which may be determined by ethical considerations as well as the patient's response. It is shown that one can choose these probabilities in order to center dose level assignments unimodally around any target quantile of interest. Estimation of the quantile is discussed; the maximum likelihood estimator and its variance are derived under a two-parameter logistic distribution, and the maximum likelihood estimator is compared with other nonparametric estimators. Random walk rules have clear advantages: they are simple to implement, and finite and asymptotic distribution theory is completely worked out. For a specific random walk rule, we compute finite and asymptotic properties and give examples of its use in planning studies. Having the finite distribution theory available and tractable obviates the need for elaborate simulation studies to analyze the properties of the design. The small sample properties of our rule, as determined by exact theory, compare favorably to those of the continual reassessment method, determined by simulation.
Likelihood Functions, Biometry, Clinical Trials, Phase I as Topic, Dose-Response Relationship, Drug, Drug-Related Side Effects and Adverse Reactions, up-and-down designs, toxicity studies, Applications of statistics to biology and medical sciences; meta analysis, small sample distribution theory, Sequential statistical design, Random Allocation, adaptive designs, Pharmaceutical Preparations, Humans, quantile estimation, Cyclophosphamide, Bone Marrow Transplantation, Randomized Controlled Trials as Topic
Likelihood Functions, Biometry, Clinical Trials, Phase I as Topic, Dose-Response Relationship, Drug, Drug-Related Side Effects and Adverse Reactions, up-and-down designs, toxicity studies, Applications of statistics to biology and medical sciences; meta analysis, small sample distribution theory, Sequential statistical design, Random Allocation, adaptive designs, Pharmaceutical Preparations, Humans, quantile estimation, Cyclophosphamide, Bone Marrow Transplantation, Randomized Controlled Trials as Topic
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