4 ms·
The article is completely misleading in this regard. Every modern clinical trial looks for these sub-populations. The article even states: Sixty percent of
by cowsandmilk 13y ago
The article is completely misleading in this regard. Every modern clinical trial looks for these sub-populations. The article even states:
Sixty percent of the new drugs in the works at
Genentech/Roche are being developed with a companion
diagnostic test to identify the patients who are most
likely to benefit.
That said, it is extremely frequent that clinical trials that follow up on these sub-population observances find them to be statistical anomalies. When you have 100 ways to subdivide your populations, you expect to have some anomalies at a typical 5% confidence level.
The article points to I-SPY 2 as the future of clinical trials, making it sound like bayesian analysis is something novel to solely this clinical trial. As is alluded to in what you call the "defensive blog post", this is now standard practice in clinical trial design at most pharma companies. These companies don't like to throw 9 figures down the drain and they recognize that adaptive trial designs can get them statistical significance at lower cost while determining optimal treatment.
- ronaldx 13y agoI call it "defensive" because the answer is not simply "yes" and I think it's a poor position to view clinical trials uncritically. Clinical trials may indeed work, but it's absolutely not clear that they are optimally designed. Although few people on this thread are experts, there are a plethora of different comments which illustrate the impossibility of perfect clinical trial design - there are always improvements that could be made and subjective decisions that have to be taken. The point that you make about pharma companies being profit-making companies could equally be phrased as a very strong criticism: that any pharma clinical trial design is likely to be heavily biased by their desire to sell their most profitable ("optimal") products.