Evidence map›Paper›PMID 35895751›Full record

ArticleBritish journal of clinical pharmacology2022

Dose escalations in phase I studies: Feasibility of interpreting blinded pharmacodynamic data.

Gerardus J Hassing, Michiel J van Esdonk, Gerard J P van Westen, Adam F Cohen, Jacobus Burggraaf, Pim Gal

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Article in British journal of clinical pharmacology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
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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

6 authors.

Gerardus J HassingCentre for Human Drug Research, Leiden, the Netherlands.ORCID 0000-0002-7979-3546
Michiel J van EsdonkCentre for Human Drug Research, Leiden, the Netherlands.ORCID 0000-0001-8159-0273
Gerard J P van WestenLeiden Academic Centre for Drug Research, Leiden, the Netherlands.
Adam F CohenCentre for Human Drug Research, Leiden, the Netherlands.ORCID 0000-0001-7452-6222
Jacobus BurggraafCentre for Human Drug Research, Leiden, the Netherlands.ORCID 0000-0001-7912-0918
Pim GalCentre for Human Drug Research, Leiden, the Netherlands.ORCID 0000-0001-7622-9029

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsDuring phase I study conduct, blinded data are reviewed to predict the safety of increasing the dose level. The aim of the present study was to describe the probability that effects are observed in blinded evaluations of data in a simulated phase I study design.

methodsAn application was created to simulate blinded pharmacological response curves over time for 6 common safety/efficacy measurements in phase I studies for 1 or 2 cohorts (6 active, 2 placebo per cohort). Effect sizes between 0 and 3 between-measurement standard deviations (SDs) were simulated. Each set of simulated graphs contained the individual response and mean ± SD over time. Reviewers (n = 34) reviewed a median of 100 simulated datasets and indicated whether an effect was present.

resultsIncreasing effect sizes resulted in a higher chance of the effect being identified by the blinded reviewer. On average, 6% of effect sizes of 0.5 between-measurement SD were correctly identified, increasing to 72% in 3.0 between-measurement SD effect sizes. In contrast, on average 92-95% of simulations with no effect were correctly identified, with little effect of between-measurement variability in single cohort simulations. Adding a dataset of a second cohort at half the simulated dose did not appear to improve the interpretation.

conclusionOur analysis showed that effect sizes <2× the between-measurement SD of the investigated outcome frequently go unnoticed by blinded reviewers, indicating that the weight given to these blinded analyses in current phase I practice is inappropriate and should be re-evaluated.

Indexed as

Clinical Trials, Phase I as TopicData Interpretation, StatisticalFeasibility StudiesHumansclinical trialsdrug developmentpharmacodynamicsphase I

Identifiers

PMID35895751

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