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Hameiri B, Moore-Berg SL. Intervention Tournaments: An Overview of Concept, Design, and Implementation. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2022; 17:1525-1540. [PMID: 35580273 PMCID: PMC9634285 DOI: 10.1177/17456916211058090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
A large portion of research in the social sciences is devoted to using interventions to combat societal and social problems, such as prejudice, discrimination, and intergroup conflict. However, these interventions are often developed using the theories and/or intuitions of the individuals who developed them and evaluated in isolation without comparing their efficacy with other interventions. Here, we make the case for an experimental design that addresses such issues: an intervention tournament-that is, a study that compares several different interventions against a single control and uses the same standardized outcome measures during assessment and participants drawn from the same population. We begin by highlighting the utility of intervention tournaments as an approach that complements other, more commonly used approaches to addressing societal issues. We then describe various approaches to intervention tournaments, which include crowdsourced, curated, and in-house-developed intervention tournaments, and their unique characteristics. Finally, we discuss practical recommendations and key design insights for conducting such research, given the existing literature. These include considerations of intervention-tournament deployment, characteristics of included interventions, statistical analysis and reporting, study design, longitudinal and underlying psychological mechanism assessment, and theoretical ramifications.
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Affiliation(s)
- Boaz Hameiri
- The Program in Conflict Resolution and
Mediation, School of Social and Policy Studies, Tel Aviv University
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2
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Khan T, Khalid M, Dunford B, Nguyen T, Wise A, Heigle B, Shepard S, Kee M, Hillman C, Ottwell R, Hartwell M, Vassar M. Incomplete Reporting of Patient-Reported Outcomes in Multiple Sclerosis: A Meta-Epidemiological Study of Randomized Controlled Trials. Mult Scler Relat Disord 2022; 63:103819. [DOI: 10.1016/j.msard.2022.103819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 03/25/2022] [Accepted: 04/21/2022] [Indexed: 11/28/2022]
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3
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Viswanath DI, Liu HC, Huston DP, Chua CYX, Grattoni A. Emerging biomaterial-based strategies for personalized therapeutic in situ cancer vaccines. Biomaterials 2022; 280:121297. [PMID: 34902729 PMCID: PMC8725170 DOI: 10.1016/j.biomaterials.2021.121297] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 11/19/2021] [Accepted: 11/29/2021] [Indexed: 01/03/2023]
Abstract
Landmark successes in oncoimmunology have led to development of therapeutics boosting the host immune system to eradicate local and distant tumors with impactful tumor reduction in a subset of patients. However, current immunotherapy modalities often demonstrate limited success when involving immunologically cold tumors and solid tumors. Here, we describe the role of various biomaterials to formulate cancer vaccines as a form of cancer immunotherapy, seeking to utilize the host immune system to activate and expand tumor-specific T cells. Biomaterial-based cancer vaccines enhance the cancer-immunity cycle by harnessing cellular recruitment and activation against tumor-specific antigens. In this review, we discuss biomaterial-based vaccine strategies to induce lymphocytic responses necessary to mediate anti-tumor immunity. We focus on strategies that selectively attract dendritic cells via immunostimulatory gradients, activate them against presented tumor-specific antigens, and induce effective cross-presentation to T cells in secondary lymphoid organs, thereby generating immunity. We posit that personalized cancer vaccines are promising targets to generate long-term systemic immunity against patient- and tumor-specific antigens to ensure long-term cancer remission.
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Affiliation(s)
- Dixita Ishani Viswanath
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX, USA; Texas A&M University College of Medicine, Bryan & Houston, TX, USA
| | - Hsuan-Chen Liu
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX, USA
| | - David P Huston
- Texas A&M University College of Medicine, Bryan & Houston, TX, USA
| | | | - Alessandro Grattoni
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX, USA; Department of Surgery, Houston Methodist Hospital, Houston, TX, USA; Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX, USA.
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Rückbeil MV, Manolov M, Hilgers RD. The Choice of a Randomization Procedure in Survival Studies with Nonproportional Hazards. Stat Biopharm Res 2021. [DOI: 10.1080/19466315.2021.1952894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Martin Manolov
- Institute for Computational Genomics, RWTH Aachen University, Aachen, Germany
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Uschner D. Randomization-based inference in the presence of selection bias. Stat Med 2021; 40:2212-2229. [PMID: 33561882 DOI: 10.1002/sim.8898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 12/24/2020] [Accepted: 01/16/2021] [Indexed: 11/05/2022]
Abstract
For the analysis of clinical trials, the study participants are usually assumed to be representative sample of a target population. This assumption is rarely fulfilled in clinical trials, and particularly not if the sample size is small. In addition, covariate imbalances may affect the trial. Randomization tests provide a nonparametric analysis method of the treatment effect that does not rely on population-based assumptions. We propose a nonparametric statistical model that yields a formal basis for randomization tests. We adapt the model for the presence of covariate imbalance in the form of selection bias and investigate the effects of bias on the rejection probability of the randomization test using Monte Carlo simulations. Finally, we show that ancillary statistics can be used to control for the influence of bias. We show that covariate imbalance leads to an inflation of the type I error probability. The proposed nonparametric model allows for the use of ancillary statistics that yield an unbiased adjusted randomization test.
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Affiliation(s)
- Diane Uschner
- The Biostatistics Center, George Washington University, Rockville, Maryland, USA
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Acute Reperfusion Decision-Making in Stroke Patients with Comorbidities: Further Unmasking UNMASK-EVT. Can J Neurol Sci 2020; 48:5-6. [PMID: 32799950 DOI: 10.1017/cjn.2020.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Smith LH. Selection Mechanisms and Their Consequences: Understanding and Addressing Selection Bias. CURR EPIDEMIOL REP 2020. [DOI: 10.1007/s40471-020-00241-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Hagendorff A, Doenst T, Falk V. Echocardiographic assessment of functional mitral regurgitation: opening Pandora's box? ESC Heart Fail 2019; 6:678-685. [PMID: 31347297 PMCID: PMC6676284 DOI: 10.1002/ehf2.12491] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 06/11/2019] [Indexed: 12/26/2022] Open
Abstract
Two recent trials of transcatheter mitral-valve repair in patients with functional mitral regurgitation (FMR) presented opposing results for the MitraClip® compared to medical therapy alone. The conflicting results gave rise to intensive discussions about assessment of mitral valve regurgitation (MR). A recent editorial viewpoint provided a potential explanation presenting a new pathophysiologic concept. However, the echocardiographic characterization of both trials' patients is inconsistent and the discussed concepts appear to suffer from plausibility weaknesses. It is well conceivable that limitations in the echocardiographic assessment of the trial patients introduced a bias regarding the selection of patients with severe (or less severe) MR that may be a more plausible explanation for the differences in outcome. We here illustrate our viewpoint regarding the two MitraClip trials and also illustrate the difficulties in assessing functional MR properly. It may indeed be "opening Pandora's box", but we will also make an attempt to provide a solution.
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Affiliation(s)
| | - Torsten Doenst
- Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
| | - Volkmar Falk
- Department of Cardiac Surgery, German Heart Center, Berlin, Germany
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Rückbeil MV, Hilgers RD, Heussen N. Randomization in survival studies: An evaluation method that takes into account selection and chronological bias. PLoS One 2019; 14:e0217946. [PMID: 31158260 PMCID: PMC6546249 DOI: 10.1371/journal.pone.0217946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/21/2019] [Indexed: 11/23/2022] Open
Abstract
The random allocation of patients to treatments is a crucial step in the design and conduct of a randomized controlled trial. For this purpose, a variety of randomization procedures is available. In the case of imperfect blinding, the extent to which a randomization procedure forces balanced group sizes throughout the allocation process affects the predictability of allocations. As a result, some randomization procedures perform superior with respect to selection bias, whereas others are less susceptible to chronological bias. The choice of a suitable randomization procedure therefore depends on the expected risk for selection and chronological bias within the particular study in question. To enable a sound comparison of different randomization procedures, we introduce a model for the combined effect of selection and chronological bias in randomized studies with a survival outcome. We present an evaluation method to quantify the influence of bias on the test decision of the log-rank test in a randomized parallel group trial with a survival outcome. The effect of selection and chronological bias and the dependence on the study setting are illustrated in a sensitivity analysis. We conclude with a case study to showcase the application of our model for comparing different randomization procedures in consideration of the expected type I error probability.
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Affiliation(s)
| | | | - Nicole Heussen
- Department of Medical Statistics, RWTH Aachen University, Aachen, Germany
- Center for Biostatistics and Epidemiology, Sigmund Freud Private University, Vienna, Austria
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Sverdlov O, Ryeznik Y. Implementing unequal randomization in clinical trials with heterogeneous treatment costs. Stat Med 2019; 38:2905-2927. [DOI: 10.1002/sim.8160] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 12/28/2018] [Accepted: 03/15/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Oleksandr Sverdlov
- Early Development BiostatisticsNovartis Pharmaceuticals East Hanover New Jersey
| | - Yevgen Ryeznik
- Department of MathematicsUppsala University Uppsala Sweden
- Department of Pharmaceutical BiosciencesUppsala University Uppsala Sweden
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Ryeznik Y, Sverdlov O, Hooker AC. Implementing Optimal Designs for Dose-Response Studies Through Adaptive Randomization for a Small Population Group. AAPS JOURNAL 2018; 20:85. [PMID: 30027336 DOI: 10.1208/s12248-018-0242-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 06/18/2018] [Indexed: 11/30/2022]
Abstract
In dose-response studies with censored time-to-event outcomes, D-optimal designs depend on the true model and the amount of censored data. In practice, such designs can be implemented adaptively, by performing dose assignments according to updated knowledge of the dose-response curve at interim analysis. It is also essential that treatment allocation involves randomization-to mitigate various experimental biases and enable valid statistical inference at the end of the trial. In this work, we perform a comparison of several adaptive randomization procedures that can be used for implementing D-optimal designs for dose-response studies with time-to-event outcomes with small to moderate sample sizes. We consider single-stage, two-stage, and multi-stage adaptive designs. We also explore robustness of the designs to experimental (chronological and selection) biases. Simulation studies provide evidence that both the choice of an allocation design and a randomization procedure to implement the target allocation impact the quality of dose-response estimation, especially for small samples. For best performance, a multi-stage adaptive design with small cohort sizes should be implemented using a randomization procedure that closely attains the targeted D-optimal design at each stage. The results of the current work should help clinical investigators select an appropriate randomization procedure for their dose-response study.
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Affiliation(s)
- Yevgen Ryeznik
- Department of Mathematics, Uppsala University, Room Å14133 Lägerhyddsvägen 1, Hus 1, 6 och 7, 751 06, Uppsala, Sweden. .,Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden.
| | - Oleksandr Sverdlov
- Early Development Biostatistics, Novartis Institutes for Biomedical Research, East Hannover, New Jersey, USA
| | - Andrew C Hooker
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
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Ryeznik Y, Sverdlov O. A comparative study of restricted randomization procedures for multiarm trials with equal or unequal treatment allocation ratios. Stat Med 2018; 37:3056-3077. [DOI: 10.1002/sim.7817] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 03/26/2018] [Accepted: 04/19/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Yevgen Ryeznik
- Department of Mathematics; Uppsala University; Uppsala Sweden
- Department of Pharmaceutical Biosciences; Uppsala University; Uppsala Sweden
| | - Oleksandr Sverdlov
- Early Development Biostatistics; Novartis Institutes for Biomedical Research; East Hanover NJ USA
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Hilgers RD, Bogdan M, Burman CF, Dette H, Karlsson M, König F, Male C, Mentré F, Molenberghs G, Senn S. Lessons learned from IDeAl - 33 recommendations from the IDeAl-net about design and analysis of small population clinical trials. Orphanet J Rare Dis 2018; 13:77. [PMID: 29751809 PMCID: PMC5948846 DOI: 10.1186/s13023-018-0820-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 05/01/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND IDeAl (Integrated designs and analysis of small population clinical trials) is an EU funded project developing new statistical design and analysis methodologies for clinical trials in small population groups. Here we provide an overview of IDeAl findings and give recommendations to applied researchers. METHOD The description of the findings is broken down by the nine scientific IDeAl work packages and summarizes results from the project's more than 60 publications to date in peer reviewed journals. In addition, we applied text mining to evaluate the publications and the IDeAl work packages' output in relation to the design and analysis terms derived from in the IRDiRC task force report on small population clinical trials. RESULTS The results are summarized, describing the developments from an applied viewpoint. The main result presented here are 33 practical recommendations drawn from the work, giving researchers a comprehensive guidance to the improved methodology. In particular, the findings will help design and analyse efficient clinical trials in rare diseases with limited number of patients available. We developed a network representation relating the hot topics developed by the IRDiRC task force on small population clinical trials to IDeAl's work as well as relating important methodologies by IDeAl's definition necessary to consider in design and analysis of small-population clinical trials. These network representation establish a new perspective on design and analysis of small-population clinical trials. CONCLUSION IDeAl has provided a huge number of options to refine the statistical methodology for small-population clinical trials from various perspectives. A total of 33 recommendations developed and related to the work packages help the researcher to design small population clinical trial. The route to improvements is displayed in IDeAl-network representing important statistical methodological skills necessary to design and analysis of small-population clinical trials. The methods are ready for use.
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Affiliation(s)
- Ralf-Dieter Hilgers
- Department of Medical Statistics, RWTH Aachen University, Pauwelsstr. 19, D-52074, Aachen, Germany.
| | - Malgorzata Bogdan
- Department of Medical Statistics, RWTH Aachen University, Pauwelsstr. 19, D-52074, Aachen, Germany
| | - Carl-Fredrik Burman
- Department of Medical Statistics, RWTH Aachen University, Pauwelsstr. 19, D-52074, Aachen, Germany
| | - Holger Dette
- Department of Medical Statistics, RWTH Aachen University, Pauwelsstr. 19, D-52074, Aachen, Germany
| | - Mats Karlsson
- Department of Medical Statistics, RWTH Aachen University, Pauwelsstr. 19, D-52074, Aachen, Germany
| | - Franz König
- Department of Medical Statistics, RWTH Aachen University, Pauwelsstr. 19, D-52074, Aachen, Germany
| | - Christoph Male
- Department of Medical Statistics, RWTH Aachen University, Pauwelsstr. 19, D-52074, Aachen, Germany
| | - France Mentré
- Department of Medical Statistics, RWTH Aachen University, Pauwelsstr. 19, D-52074, Aachen, Germany
| | - Geert Molenberghs
- Department of Medical Statistics, RWTH Aachen University, Pauwelsstr. 19, D-52074, Aachen, Germany
| | - Stephen Senn
- Department of Medical Statistics, RWTH Aachen University, Pauwelsstr. 19, D-52074, Aachen, Germany
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