Joint Statistical Meeting in Seattle, 8th-13th August 2015

Laura Flight, along with Professor Steven Julious, attended the Joint Statistical Meeting (JSM) conference in Seattle from the 8th to 13th August 2015. This conference brings together a number of statistical societies across the world creating the largest statistics conference in North America. This year the conference was attended by over 6,000 people.

At the conference Laura presented work from an NIHR Research Methods Fellowship on “Assessing the current and potential use of adaptive study designs in emergency medicine clinical trials”.

Adaptive designs are an alternative approach to conducting a clinical trial. Rather than waiting until the trial ends to look at the data, we use specially developed methods to examine data as the trial is progressing. This information can then inform whether we should make changes or adaptations to the trial. For example we might decide to stop the trial early because we can already show a new treatment is much better than the alternative.

In emergency medicine, the time it takes for patients to provide us with data about the outcome we are interested in (the primary outcome) is often short compared to the length of time we recruit patients into the trial. This makes them ideal candidates for an adaptive design. We can examine data early in the trial leaving time to make any changes suggested from the ‘interim’ analysis.

The talk summarised results from an audit of trials published in three emergency medicine journals. Our aim was to determine whether adaptive designs are being used in emergency medicine and whether there is potential for them to be used more.

Out of 188 trials only 19 used an adaptive study design. Nearly all (93%, 154/165) of the non-adaptive trials had the potential to use adaptive methods if we compared the amount of time required for patients to reach the primary outcome and the length of recruitment.

The use of adaptive designs in these emergency medicine trials was limited, despite their suitability. We recommend all emergency medicine clinical trials should consider using adaptive study designs, if practical and logistical factors allow.

This is independent research arising from an NIHR Research Methods Fellowship, RMFI-2013-04-11, supported by the National Institute for Health Research. The views expressed in this presentation are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research, the Department of Health or the University of Sheffield.