The use of randomized clinical trials to evaluate drugs and medical devices is a complex and increasingly expensive process, which is plagued by disappointingly low rates of success. Innovations in clinical trial methodology, and specifically adaptive clinical trials, can address many ofthe limitations of conventional trial designs and have the potential to improve the efficiency and success rates of clinical research, the quality of resulting scientific data, and the protection of human subjects. Optimal approaches-including both statistical methods and organizational processes-iforthe collaborative development and implementation of confirmatory, adaptive clinical trials remain unclear. This project will address that gap. The process of clinical trial development within the NINDS-supported Neurological Emergencies Treatment Trials (NETT) networl

Public Health Relevance

(See Instructions): Randomized clinical trials are the cornerstone for acceptance of new therapies by regulatory agencies and clinicians. Currently, this process is slow and cumbersome and may lead to false conclusions about the utility of new treatments. This project will identify effective processes for the design and initiation of high-quality, confirmatory, adaptive clinical trials. These methods can be used to accelerate the evaluation of promising new therapies, conserve resources and support public health by improving the rate and quality of drug and device development.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01NS073476-03
Application #
8323322
Study Section
Special Emphasis Panel (ZRG1-ETTN-A (50))
Program Officer
Morris, Jill A
Project Start
2010-09-27
Project End
2014-08-31
Budget Start
2012-09-01
Budget End
2014-08-31
Support Year
3
Fiscal Year
2012
Total Cost
$566,876
Indirect Cost
$162,150
Name
University of Michigan Ann Arbor
Department
Emergency Medicine
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Meurer, William J; Barsan, William G (2014) Spinal cord injury neuroprotection and the promise of flexible adaptive clinical trials. World Neurosurg 82:e541-6
Zahuranec, Darin B; Lisabeth, Lynda D; Sánchez, Brisa N et al. (2014) Intracerebral hemorrhage mortality is not changing despite declining incidence. Neurology 82:2180-6
Connor, Jason T; Elm, Jordan J; Broglio, Kristine R et al. (2013) Bayesian adaptive trials offer advantages in comparative effectiveness trials: an example in status epilepticus. J Clin Epidemiol 66:S130-7
Johnston, S Claiborne; Easton, J Donald; Farrant, Mary et al. (2013) Platelet-oriented inhibition in new TIA and minor ischemic stroke (POINT) trial: rationale and design. Int J Stroke 8:479-83
Skolarus, L E; Meurer, W J; Burke, J F et al. (2012) Effect of insurance status on postacute care among working age stroke survivors. Neurology 78:1590-5