Conditionally unbiased estimation in phase II/III clinical trials with early stopping for futility

Seamless phase II/III clinical trials combine traditional phases II and III into a single trial that is conducted in two stages, with stage 1 used to answer phase II objectives such as treatment selection and stage 2 used for the confirmatory analysis, which is a phase III objective. Although seamless phase II/III clinical trials are efficient because the confirmatory analysis includes phase II data from stage 1, inference can pose statistical challenges. In this paper, we consider point estimation following seamless phase II/III clinical trials in which stage 1 is used to select the most effective experimental treatment and to decide if, compared with a control, the trial should stop at stage 1 for futility. If the trial is not stopped, then the phase III confirmatory part of the trial involves evaluation of the selected most effective experimental treatment and the control. We have developed two new estimators for the treatment difference between these two treatments with the aim of reducing bias conditional on the treatment selection made and on the fact that the trial continues to stage 2. We have demonstrated the properties of these estimators using simulations

A comparison of methods for constructing confidence intervals after phase II/III clinical trials

Recently, in order to accelerate drug development, trials that use adaptive seamless designs such as phase II/III clinical trials have been proposed. Phase II/III clinical trials combine traditional phases II and III into a single trial that is conducted in two stages. Using stage 1 data, an interim analysis is performed to answer phase II objectives and after collection of stage 2 data, a final confirmatory analysis is performed to answer phase III objectives. In this paper we consider phase II/III clinical trials in which, at stage 1, several experimental treatments are compared to a control and the apparently most effective experimental treatment is selected to continue to stage 2. Although these trials are attractive because the confirmatory analysis includes phase II data from stage 1, the inference methods used for trials that compare a single experimental treatment to a control and do not have an interim analysis are no longer appropriate. Several methods for analysing phase II/III clinical trials have been developed. These methods are recent and so there is little literature on extensive comparisons of their characteristics. In this paper we review and compare the various methods available for constructing confidence intervals after phase II/III clinical trials.

Data-driven treatment selection for seamless phase II/III trials incorporating early-outcome data

Seamless phase II/III clinical trials are conducted in two stages with treatment selection at the first stage. In the first stage, patients are randomized to a control or one of k > 1 experimental treatments. At the end of this stage, interim data are analysed, and a decision is made concerning which experimental treatment should continue to the second stage. If the primary endpoint is observable only after some period of follow-up, at the interim analysis data may be available on some early outcome on a larger number of patients than those for whom the primary endpoint is available. These early endpoint data can thus be used for treatment selection. For two previously proposed approaches, the power has been shown to be greater for one or other method depending on the true treatment effects and correlations. We propose a new approach that builds on the previously proposed approaches and uses data available at the interim analysis to estimate these parameters and then, on the basis of these estimates, chooses the treatment selection method with the highest probability of correctly selecting the most effective treatment. This method is shown to perform well compared with the two previously described methods for a wide range of true parameter values. In most cases, the performance of the new method is either similar to or, in some cases, better than either of the two previously proposed methods.

A comparison of methods for treatment selection in seamless phase II/III clinical trials incorporating information on short-term endpoints

In an adaptive seamless phase II/III clinical trial interim analysis, data are used for treatment selection, enabling resources to be focused on comparison of more effective treatment(s) with a control. In this paper, we compare two methods recently proposed to enable use of short-term endpoint data for decision-making at the interim analysis. The comparison focuses on the power and the probability of correctly identifying the most promising treatment. We show that the choice of method depends on how well short-term data predict the best treatment, which may be measured by the correlation between treatment effects on short- and long-term endpoints.

Flexible selection of a single treatment incorporating short-term endpoint information in a phase II/III clinical trial

Seamless phase II/III clinical trials in which an experimental treatment is selected at an interim analysis have been the focus of much recent research interest. Many of the methods proposed are based on the group sequential approach. This paper considers designs of this type in which the treatment selection can be based on short-term endpoint information for more patients than have primary endpoint data available. We show that in such a case, the familywise type I error rate may be inflated if previously proposed group sequential methods are used and the treatment selection rule is not specified in advance. A method is proposed to avoid this inflation by considering the treatment selection that maximises the conditional error given the data available at the interim analysis. A simulation study is reported that illustrates the type I error rate inflation and compares the power of the new approach with two other methods: a combination testing approach and a group sequential method that does not use the short-term endpoint data, both of which also strongly control the type I error rate. The new method is also illustrated through application to a study in Alzheimer's disease. © 2015 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

mer-[RuCl3(P-P)H2O] (P-P=dppb or diop) as a starting material for the synthesis of binuclear complexes. Crystallographic structures of [(dppb)ClRu-mu(Cl)(3)-RuCl(dppb)] and [(eta(6)-C6H6)Ru-mu(Cl)(3)-RuCl(dppb)]. Imine hydrogenation using mono- and binuclear ruthenium complexes

The reactivity of the mer-[RuCl3(dppb)H2O] complex (1) with di-hydrogen shows that the products formed depend on the conditions of the reaction, i.e., solvents and presence or absence of a base. The new mixed-valence complexes [(diop)ClRu-(h-Cl)(3)-RuCl(dppb)] (3), [(binap)CIRu-(p-Cl)(3)-RuCl(dppb)] (4), [(PPh3)(2)ClRu-(mu-Cl)(3)-RuCl(dppb)] (6), [(dppn)ClRu-(mu-Cl)(3)-RuCl(dppb)] (7), [(P-ptol(3))(2)ClRu-(mu-Cl)(3)-RuCl(dppb)] (8), [(SbPh3)(2)ClRu-(mu-Cl)(3)-RuCl(dppb)] (9), [(eta(6)-C6H6)Ru-(mu-Cl)(3)-RuCl(dppb)] (11) and the known mixed-valence [(dppb)CIRu-(mu-Cl)(3)-RuCl(dppb)] (5) and [(diop)ClRu-(mu-Cl)(3)-RuCl(diop)] (10) were synthesized from complexes (1) or (2) using a methodology developed in our research group. The known complexes [(dppb)ClRu-(mu-Cl)(2)-RuCl(dppb)] (12), [(dppb)(CO)Ru-(mu-Cl)(3)-RuCl(dppb)] (13) and [H2NEt2][(dppb)ClRu-(mu-Cl)(3)-RuCl(dppb)] (14) were synthesized by changing the reaction conditions between mer-[RuCl3(dppb)H2O] (1) and dihydrogen. The crystal structures of (5) and (11) were determined by single-crystal X-ray diffraction. Some of the complexes described here are effective pre-catalysts for the hydrogenation of imines. Preliminary results on the homogeneous hydrogenation of the imines Ph-CH2-N=CH-Ph and Ph-N=CH-Ph are presented. (C) 2004 Elsevier Ltd. All rights reserved.

A dimensão política da educação ambiental: reflexões sobre os trabalhos dos encontros de pesquisa em Educação Ambiental (I, II, III EPEAS)

Pós-graduação em Educação - IBRC

Levantamento de raízes e tubérculos nos assentamentos rurais Araras I, II, III e IV, no município de Araras, SP

Com a disseminação da agricultura industrial, com grande utilização de insumos tecnológicos, mecanizada e fundamentada num número reduzido de espécies e variedades de plantas cultivadas, os modos de produção autóctone têm sofrido pressões em todo mundo. Entre estas, citam-se a modernização do campo, a perda de terras para agricultura comercial em larga escala e a emigração dos jovens em busca de melhores condições de vida, que acarretam grandes mudanças para estes sistemas agrícolas. As comunidades de agricultores de subsistência são detentoras de uma gama de variedades de diversas espécies cultivadas, sendo que essa diversidade é um fator adaptativo importante para o agricultor ante as variações ambientais, climáticas, biológicas e socioeconômicas, além de ser importante para a segurança do sistema alimentar mundial. Isto faz com que estes agricultores se tornem importantes parceiros para programas de conservação in situ de plantas cultivadas. No Brasil, assentamentos rurais são formados por agricultores de diversas origens, e são locais onde a agricultura é parcialmente voltada para a subsistência. Dentre a grande diversidade de plantas cultivadas para subsistência, as raízes e os tubérculos constituem, depois dos cereais, a principal fonte de alimento para a população humana. O presente estudo visou levantar as espécies de raízes e tubérculos cultivados nos Assentamentos Rurais Araras I, II, III e IV, no município de Araras, São Paulo, e analisou a potencialidade dos pequenos agricultores das assentamentos como mantedores de agrobiodiversidade. A pesquisa se deu através de entrevistas estruturadas e semi-estruturadas, onde os agricultores entrevistados forma selecionados de maneira aleatória e estratificada entre os quatro assentamentos. Os dados coletados foram analisados de maneira descritiva. Os resultados...(Resumo completo, clicar acesso eletrônico abaixo)

Functionalized Adamantane Tectons Used in the Design of Mixed-Ligand Copper(II) 1,2,4-Triazolyl/Carboxylate Metal–Organic Frameworks

Bistriazoles, 1,3-bis(1,2,4-triazol-4-yl)propane (tr2pr) and 1,3-bis(1,2,4-triazol-4-yl)adamantane (tr2ad), were examined in combination with the rigid tetratopic 1,3,5,7-adamantanetetracarboxylic acid (H4-adtc) platform for the construction of neutral heteroleptic copper(II) metal−organic frameworks. Two coordination polymers, [{Cu4(OH)2(H2O)2}{Cu4(OH)2}(tr2pr)2(H-adtc)4]·2H2O (1) and [Cu4(OH)2(tr2ad)2(H-adtc)2(H2O)2]·3H2O (2), were synthesized and structurally characterized. In complexes 1 and 2, the N1,N2-1,2,4-triazolyl (tr) and μ3-OH− groups serve as complementary bridges between adjacent metal centers supporting the tetranuclear dihydroxo clusters. The structure of 1 represents a unique association of two different kinds of centrosymmetrical {Cu4(OH)2} units in a tight 3D framework, while in compound 2, another configuration type of acentric tetranuclear metal clusters is organized in a layered 3,6-hexagonal motif. In both cases, the {Cu4(OH)2} secondary building block and trideprotonated carboxylate H-adtc3− can be viewed as covalently bound six- and three-connected nodes that define the net topology. The tr ligands, showing μ3- or μ4-binding patterns, introduce additional integrating links between the neighboring {Cu4(OH)2} fragments. A variable-temperature magnetic susceptibility study of 2 demonstrates strong antiferromagnetic intracluster coupling (J1 = −109 cm−1 and J2 = −21 cm−1), which combines for the bulk phase with a weak antiferromagnetic intercluster interaction (zj = −2.5 cm−1).

Historia de la provincia de la corona de Aragon de la... orden de los Ermitaños de... San Agustin... : parte II, III, y IV, contienen las fundaciones de los conventos de religiosos ...

Sign.: []2, 2[calderón]4, A-Z4, 2A-2Z4, 3A-3Q4, 3R2

Decada legal, en que contrahidas a diez las Leyes de estos Reynos, se van poniendo por resumen, y baxo un contexto las de cada parte de la Decada : Tomo primero ; que contiene una idea de la legislacion ... mostrando las epocas de su formacion ... con las leyes Iª, IIª, IIIª y IVª de ella

Contiene: Leyes religiosa y regia de Castilla : primera y segunda de la Decada ; Leyes Magistratoria y Popular : tercera y quarta de la Decada