Decision-making in a phase II clinical trial: a new approach combining Bayesian and frequentist concepts

The aim of a phase H clinical trial is to decide whether or not to develop an experimental therapy further through phase III clinical evaluation. In this paper, we present a Bayesian approach to the phase H trial, although we assume that subsequent phase III clinical trials will hat,e standard frequentist analyses. The decision whether to conduct the phase III trial is based on the posterior predictive probability of a significant result being obtained. This fusion of Bayesian and frequentist techniques accepts the current paradigm for expressing objective evidence of therapeutic value, while optimizing the form of the phase II investigation that leads to it. By using prior information, we can assess whether a phase II study is needed at all, and how much or what sort of evidence is required. The proposed approach is illustrated by the design of a phase II clinical trial of a multi-drug resistance modulator used in combination with standard chemotherapy in the treatment of metastatic breast cancer. Copyright (c) 2005 John Wiley & Sons, Ltd.

Directed search with real options

While search is normally modelled by economists purely in terms of decisions over making observations, this paper models it as a process in which information is gained through feedback from innovatory product launches. The information gained can then be used to decide whether to exercise real options. In the model the initial decisions involve a product design and the scale of production capacity. There are then real options to change these factors based on what is learned. The case of launching product variants in parallel is also considered. Under ‘true’ uncertainty, the model can be seen in terms of heuristic decision-making based on subjective beliefs with limited foresight. Search costs, the values of the real options, beliefs, and the cost of capital are all shown to be significant in determining the search path.

Selecting object pairs for action: is the active object always first?

Perception is linked to action via two routes: a direct route based on affordance information in the environment and an indirect route based on semantic knowledge about objects. The present study explored the factors modulating the recruitment of the two routes, in particular which factors affecting the selection of paired objects. In Experiment 1, we presented real objects among semantically related or unrelated distracters. Participants had to select two objects that can interact. The presence of distracters affected selection times, but not the semantic relations of the objects with the distracters. Furthermore, participants first selected the active object (e.g. teaspoon) with their right hand, followed by the passive object (e.g. mug), often with their left hand. In Experiment 2, we presented pictures of the same objects with no hand grip, congruent or incongruent hand grip. Participants had to decide whether the two objects can interact. Action decisions were faster when the presentation of the active object preceded the presentation of the passive object, and when the grip was congruent. Interestingly, participants were slower when the objects were semantically but not functionally related; this effect increased with congruently gripped objects. Our data showed that action decisions in the presence of strong affordance cues (real objects, pictures of congruently gripped objects) relied on sensory-motor representation, supporting the direct route from perception-to-action that bypasses semantic knowledge. However, in the case of weak affordance cues (pictures), semantic information interfered with action decisions, indicating that semantic knowledge impacts action decisions. The data support the dual-route account from perception-to-action.

Time to decide? Simplicity and congruity in comparative judgment

What is the relationship between magnitude judgments relying on directly available characteristics versus probabilistic cues? Question frame was manipulated in a comparative judgment task previously assumed to involve inference across a probabilistic mental model (e.g., “which city is largest” – the “larger” question – versus “which city is smallest” – the “smaller” question). Participants identified either the largest or smallest city (Experiments 1a, 2) or the richest or poorest person (Experiment 1b) in a three-alternative forced choice (3-AFC) task (Experiment 1) or 2-AFC task (Experiment 2). Response times revealed an interaction between question frame and the number of options recognized. When asked the smaller question, response times were shorter when none of the options were recognized. The opposite pattern was found when asked the larger question: response time was shorter when all options were recognized. These task-stimuli congruity results in judgment under uncertainty are consistent with, and predicted by, theories of magnitude comparison which make use of deductive inferences from declarative knowledge.

"To strive for economic and social justice": welfare, sexuality, and party politics in San Francisco in the 1960s

This article explores how liberal politicians like Phil Burton of San Francisco joined with welfare rights lobbyists and bureaucrats to embrace late twntieth-century notions of sexual equality through a broader reconception of economic equality brought about by the expansion of the California welfare state in the early 1960s.

Evidence of systematic approaches to innovation in facilities management

Purpose – This paper seeks to examine the nature of “service innovation” in the facilities management (FM) context. It reviews recent thinking on “service innovation” as distinct from “product innovation”. Applying these contemporary perspectives it describes UK case studies of 11 innovations in different FM organisations. These include both in-house client-based innovations and third-party innovations. Design/methodology/approach – The study described in the paper encompasses 11 different innovations that constitute a mix of process, product and practice innovations. All of the innovations stem from UK-based organisations that were subject to in-depth interviews regarding the identification, screening, commitment of resources and implementation of the selected innovations. Findings – The research suggested that service innovation is highly active in the UK FM sector. However, the process of innovation rarely followed a common formalized path. Generally, the innovations were one-shot commitments at the early stage. None of the innovations studied failed to proceed to full adoption stage. This was either due to the reluctance of participating organisations to volunteer “tested but unsuccessful” innovations or the absence of any trial methods that might have exposed an innovations shortcomings. Research limitations/implications – The selection of innovations was restricted to the UK context. Moreover, the choice of innovations was partly determined by the innovating organisation. This selection process appeared to emphasise “one-shot” high profile technological innovations, typically associated with software. This may have been at the expense of less resource intensive, bottom-up innovations. Practical implications – This paper suggests that there is a role for “research and innovation” teams within larger FM organisations, whether they are client-based or third-party. Central to this philosophy is an approach that is open to the possibility of failure. The innovations studied were risk averse with a firm commitment to proceed at the early stage. Originality/value – This paper introduces new thinking on the subject of “service innovation” to the context of FM. It presents research and development as a planned solution to innovation. This approach will enable service organisations to fully test and exploit service innovations.

Perspectives on experiences of innovation: the development of an assessment methodology appropriate to construction project organizations

The UK construction industry is in the process of trying to adopt a new culture based on the large-scale take up of innovative practices. Through the Demonstration Project process many organizations are implementing changed practices and learning from the experiences of others. This is probably the largest experiment in innovation in any industry in recent times. The long-term success will be measured by the effectiveness of embedding the new practices in the organization. As yet there is no recognized approach to measuring the receptivity of the organization to the innovation process as an indication of the likelihood of long-term development. The development of an appropriate approach is described here. Existing approaches to the measurement of the take up of innovation were reviewed and where appropriate used as the base for the development of a questionnaire. The questionnaire could be applicable to multi-organizational construction project situations such that the output could determine an individual organization's innovative practices via an innovation scorecard, a project team's approach or it could be used to survey a wide cross-section of the industry.

Age-related decline in the ability to decode emotional prosody: primary or secondary phenomenon?

Emotion processing deficits can cause catastrophic damage to a person's ability to interact socially. While it is known that older adults have difficulty identifying facial emotions, it is still not clear whether this difficulty extends to identification of the emotion conveyed by prosody. This study investigated whether the ability of older adults to decode emotional prosody falls below that of young adults after controlling for loss of hearing sensitivity and key features of cognitive ageing. Apart from frontal lobe load, only verbal IQ was associated with the age-related reduction in performance displayed by older participants, but a notable deficit existed after controlling for its effects. It is concluded that older adults may indeed have difficulty deducing the emotion conveyed by prosody, and that while this difficulty can be exaggerated by some aspects of cognitive ageing, it is primary in origin.

Detecting an impact of predation on bird populations depends on the methods used to assess the predators

Summary 1. In recent decades there have been population declines of many UK bird species, which have become the focus of intense research and debate. Recently, as the populations of potential predators have increased there is concern that increased rates of predation may be contributing to the declines. In this review, we assess the methodologies behind the current published science on the impacts of predators on avian prey in the UK. 2. We identified suitable studies, classified these according to study design (experimental ⁄observational) and assessed the quantity and quality of the data upon which any variation in predation rates was inferred. We then explored whether the underlying study methodology had implications for study outcome. 3. We reviewed 32 published studies and found that typically observational studies comprehensively monitored significantly fewer predator species than experimental studies. Data for a difference in predator abundance from targeted (i.e. bespoke) census techniques were available for less than half of the 32 predator species studied. 4. The probability of a study detecting an impact on prey abundance was strongly, positively related to the quality and quantity of data upon which the gradient in predation rates was inferred. 5. The findings suggest that if a study is based on good quality abundance data for a range of predator species then it is more likely to detect an effect than if it relies on opportunistic data for a smaller number of predators. 6. We recommend that the findings from studies which use opportunistic data, for a limited number of predator species, should be treated with caution and that future studies employ bespoke census techniques to monitor predator abundance for an appropriate suite of predators.

The design of probiotic studies to substantiate health claims

The EC Regulation No. 1924/2006 on Nutrition and Health claims made on foods has generated considerable debate and concern among scientists and industry. At the time of writing, the European Food Safety Authority (EFSA) has not approved any probiotic claims despite numerous human trials and meta-analyses showing evidence of beneficial effects. On 29th and 30th September 2010, ten independent, academic scientists with a documented record in probiotic research, met to discuss designs for future probiotic studies to demonstrate health benefits for gut and immune function. The expert panel recommended the following: (i) always formulate a precise and concrete hypothesis, and appropriate goals and parameters before starting a trial; (ii) ensure trials have sufficient sample size, such that they are adequately powered to reach statistically significant conclusions, either supporting or rejecting the a priori hypothesis, taking into account adjustment for multiple testing (this might necessitate more than one recruitment site); (iii) ensure trials are of appropriate duration; (iv) focus on a single, primary objective and only evaluate multiple parameters when they are hypothesis-driven. The panel agreed that there was an urgent need to better define which biomarkers are considered valuable for substantiation of a health claim. As a first step, the panel welcomed the publication on the day of the meeting of EFSA's draft guidance document on immune and gut health, although it came too late for study designs and dossiers to be adjusted accordingly. New validated biomarkers need to be identified in order to properly determine the range of physiological functions influenced by probiotics. In addition, validated biomarkers reflecting risk factors for disease, are required for article 14 claims (EC Regulation No. 1924/2006). Finally, the panel concluded that consensus among scientists is needed to decide appropriate clinical endpoints for trials.