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.

National Institute of Health (NIH)
National Institute of Neurological Disorders and Stroke (NINDS)
Research Project--Cooperative Agreements (U01)
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Special Emphasis Panel (ZRG1-ETTN-A (50))
Program Officer
Morris, Jill A
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University of Michigan Ann Arbor
Emergency Medicine
Schools of Medicine
Ann Arbor
United States
Zip Code
Meurer, William J; Legocki, Laurie; Mawocha, Samkeliso et al. (2016) Attitudes and opinions regarding confirmatory adaptive clinical trials: a mixed methods analysis from the Adaptive Designs Accelerating Promising Trials into Treatments (ADAPT-IT) project. Trials 17:373
Connor, Jason T; Broglio, Kristine R; Durkalski, Valerie et al. (2015) The Stroke Hyperglycemia Insulin Network Effort (SHINE) trial: an adaptive trial design case study. Trials 16:72
Legocki, Laurie J; Meurer, William J; Frederiksen, Shirley et al. (2015) Clinical trialist perspectives on the ethics of adaptive clinical trials: a mixed-methods analysis. BMC Med Ethics 16:27
Guetterman, Timothy C; Fetters, Michael D; Legocki, Laurie J et al. (2015) Reflections on the Adaptive Designs Accelerating Promising Trials Into Treatments (ADAPT-IT) Process-Findings from a Qualitative Study. Clin Res Regul Aff 32:121-130
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
Meurer, William J; Barsan, William G (2014) Spinal cord injury neuroprotection and the promise of flexible adaptive clinical trials. World Neurosurg 82:e541-6
Bleck, Thomas; Cock, Hannah; Chamberlain, James et al. (2013) The established status epilepticus trial 2013. Epilepsia 54 Suppl 6:89-92
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
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
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

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