A case for bayesianism in clinical trials

Statistics in Medicine - Tập 12 Số 15-16 - Trang 1377-1393 - 1993
Donald A. Berry1
1Institute of Statistics and Decision Sciences, Duke University, Durham, NC 27708-0251.

Tóm tắt

AbstractThis paper describes a Bayesian approach to the design and analysis of clinical trials, and compares it with the frequentist approach. Both approaches address learning under uncertainty. But they are different in a variety of ways. The Bayesian approach is more flexible. For example, accumulating data from a clinical trial can be used to update Bayesian measures, independent of the design of the trial. Frequentist measures are tied to the design, and interim analyses must be planned for frequentist measures to have meaning. Its flexibility makes the Bayesian approach ideal for analysing data from clinical trials. In carrying out a Bayesian analysis for inferring treatment effect, information from the clinical trial and other sources can be combined and used explicitly in drawing conclusions. Bayesians and frequentists address making decisions very differently. For example, when choosing or modifying the design of a clinical trial, Bayesians use all available information, including that which comes from the trial itself. The ability to calculate predictive probabilities for future observations is a distinct advantage of the Bayesian approach to designing clinical trials and other decisions. An important difference between Bayesian and frequentist thinking is the role of randomization.

Từ khóa


Tài liệu tham khảo

Barnett V., 1982, Comparative Statistical Inference

DeGroot M. H., 1970, Optimal Statistical Decisions

Freireich E. J., 1963, The effect of 6‐mercaptopurine on the duration of steroid‐induced remissions, in acute leukemia: a model for evaluation of other potentially useful therapy, Blood, 21, 699, 10.1182/blood.V21.6.699.699

10.1177/009286159102500306

10.1080/10543409108835007

Berry D. A. Wolff M. C.andSack D.‘Public health decision making: a sequential vaccine trial (with discussion)’ in Bayesian Statistics vol. 4. (Edited by Berger J. O. Bernardo J. M. Dawid A. P. Smith A. F. M.) 1992.

10.1080/01621459.1963.10500851

10.2307/2682711

10.2307/2684222

10.1007/978-1-4613-8768-8_5

10.2307/2531909

Lindley D. V., 1972, Bayes estimates for the linear model (with discussion), Journal of the Royal Statistical Association, Series B, 34, 1

Berger J. O., 1986, Statistical Decision Theory and Bayesian Analysis

DuMouchel W., 1989, Statistical Methodology in the Pharmaceutical Sciences, 509

Janicak P. G., 1988, S‐adenosyl‐methionine (SAMe) in depression: a literature review and preliminary data report, Alabama Journal of Medical Sciences, 25, 306

10.2307/2531771

Berry D. A.‘A Bayesian approach to multicenter trials and metaanalysis’ Proceeding of the Pharmaceutical Section of the American Statistical Association 1990 pp.1–10.

Eddy D. M., 1992, Meta‐Analysis by the Confidence Profile Method: The Statistical Synthesis of Evidence

Berry D. A. Berry S. M.andGillingham K.‘Bayesian metanalysis for treatment comparisons: dichotomous responses’ Proceedings of the Pharmaceutical Section of the American Statistical Association 1992.

Berry D. A., 1990, Subgroup analyses, Biometrics, 47, 1227

Berry D. A., 1989, Bayesian Statistics, 79

Good I. J., 1983, Good Thinking

Mosteller F., 1983, Clinical Trials, 13

10.1214/ss/1177012385

Spiegelhalter D. J., 1989, Bayesian Statistics, 243