Evidence map›Paper›PMID 34229728›Full record

ArticleTrials2021

TRAFIC: statistical design and analysis plan for a pragmatic early phase 1/2 Bayesian adaptive dose escalation trial in rheumatoid arthritis.

M Cole, C Yap, C Buckley, W F Ng, I McInnes, A Filer, S Siebert, A Pratt, J D Isaacs, D D Stocken

Open access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

M ColePopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
C YapClinical Trials and Statistics Unit, The Institute of Cancer Research, London, Sutton, UK.
C BuckleySchool of Immunity and Infection, University of Birmingham, Birmingham, UK.
W F NgTranslational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
I McInnesCollege of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
A FilerSchool of Immunity and Infection, University of Birmingham, Birmingham, UK.
S SiebertCollege of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
A PrattTranslational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
J D IsaacsTranslational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
D D StockenLeeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK. d.d.stocken@leeds.ac.uk.ORCID http://orcid.org/0000-0001-8031-1738
Newcastle University · GBUniversity of Birmingham · GBUniversity of Glasgow · GBInstitute of Cancer Research · GBUniversity of Leeds · GB

Funding

Medical Research Council MR/L005123/1Medical Research Council MR/P020941/1
6 · The paper itself

Abstract

backgroundAdaptive model-based dose-finding designs have demonstrated advantages over traditional rule-based designs but have increased statistical complexity but uptake has been slow especially outside of cancer trials. TRAFIC is a multi-centre, early phase trial in rheumatoid arthritis incorporating a model-based design.

methodsA Bayesian adaptive dose-finding phase I trial rolling into a single-arm, single-stage phase II trial. Model parameters for phase I were chosen via Monte Carlo simulation evaluating objective performance measures under clinically relevant scenarios and incorporated stopping rules for early termination. Potential designs were further calibrated utilising dose transition pathways. DISCUSSION: TRAFIC is an MRC-funded trial of a re-purposed treatment demonstrating that it is possible to design, fund and implement a model-based phase I trial in a non-cancer population within conventional research funding tracks and regulatory constraints. The phase I design allows borrowing of information from previous trials, all accumulated data to be utilised in decision-making, verification of operating characteristics through simulation, improved understanding for management and oversight teams through dose transition pathways. The rolling phase II design brings efficiencies in trial conduct including site and monitoring activities and cost. TRAFIC is the first funded model-based dose-finding trial in inflammatory disease demonstrating that small phase I/II trials can have an underlying statistical basis for decision-making and interpretation.

trial registrationTrials Registration: ISRCTN, ISRCTN36667085 . Registered on September 26, 2014.

Indexed as

Arthritis, RheumatoidNeoplasmsAdaptive Clinical Trials as TopicBayes TheoremClinical Trials, Phase I as TopicClinical Trials, Phase II as TopicComputer SimulationDose-Response Relationship, DrugHumansPragmatic Clinical Trials as TopicResearch DesignAdaptiveClinical trialCRMDose-findingEarly-phase

Identifiers

PMID34229728
PMCPMC8259060
OpenAlexW3181942203

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.