Response-adaptive randomization for multi-arm clinical trials using the forward looking Gittins index rule.

ABSTRACT: The Gittins index provides a well established, computationally attractive, optimal solution to a class of resource allocation problems known collectively as the multi-arm bandit problem. Its development was originally motivated by the problem of optimal patient allocation in multi-arm clinical trials. However, it has never been used in practice, possibly for the following reasons: (1) it is fully sequential, i.e., the endpoint must be observable soon after treating a patient, reducing the medical settings to which it is applicable; (2) it is completely deterministic and thus removes randomization from the trial, which would naturally protect against various sources of bias. We propose a novel implementation of the Gittins index rule that overcomes these difficulties, trading off a small de

SUBMITTER: Villar SS 

PROVIDER: S-EPMC4856210 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature