Adaptive designs for subpopulation analysis optimizing utility functions

If the response to treatment depends on genetic biomarkers, it is important to identify predictive biomarkers that define (sub‐) populations where the treatment has a positive benefit risk balance. One approach to determine relevant subpopulations are subgroup analyses where the treatment effect is estimated in biomarker positive and biomarker negative groups. Subgroup analyses are challenging because several types of risks are associated with inference on subgroups. On the one hand, by disregarding a relevant subpopulation a treatment option may be missed due to a dilution of the treatment effect in the full population. Furthermore, even if the diluted treatment effect can be demonstrated in an overall population, it is not ethical to treat patients that do not benefit from the treatment when they can be identified in advance. On the other hand, selecting a spurious subpopulation increases the risk to restrict an efficacious treatment to a too narrow fraction of a potential benefiting population. We propose to quantify these risks with utility functions and investigate nonadaptive study designs that allow for inference on subgroups using multiple testing procedures as well as adaptive designs, where subgroups may be selected in an interim analysis. The characteristics of such adaptive and nonadaptive designs are compared for a range of scenarios.

Location
Deutsche Nationalbibliothek Frankfurt am Main
Extent
Online-Ressource
Language
Englisch

Bibliographic citation
Adaptive designs for subpopulation analysis optimizing utility functions ; volume:57 ; number:1 ; year:2015 ; pages:76-89 ; extent:14
Biometrical journal ; 57, Heft 1 (2015), 76-89 (gesamt 14)

Creator
Graf, Alexandra C.
Posch, Martin
Koenig, Franz

DOI
10.1002/bimj.201300257
URN
urn:nbn:de:101:1-2022122206173714494063
Rights
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Last update
15.08.2025, 7:21 AM CEST

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Associated

  • Graf, Alexandra C.
  • Posch, Martin
  • Koenig, Franz

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