论文标题
临床药物开发中定量决策的实施和实践方面
Implementation and pratical aspects of quantitative decision-making in clinical drug development
论文作者
论文摘要
量化决策(QDM)原则解决了与结果映射到决策,信息合成和不确定性量化有关的问题。由于临床药物开发涉及一系列的决策,因此可以在不同级别应用QDM方法。在研究级别上,它可用于正确设计研究,并改善在试验期间或结束时做出的决策。在研究之前建立决策标准对于解决对快速决策的需求至关重要,这可能是实时的。在项目一级,QDM可用于根据先前研究的结果来继续,适应或停止药物开发计划。在投资组合级别,QDM可用于选择,优先级和优化开发组合,例如利用概率在预定义的时间表内达到市场访问或目标销售。对QDM及其统计性质的兴趣日益增加,导致2017年开发了社会内部QDM的跨行业和学术界特殊利益小组,以及制药行业的欧洲统计学家联合会(PSI和EFSPI)。该小组的活动包括讨论QDM示例,文献中的一些示例以及一些涵盖多种设置的真实匿名化。尽管该方法(在某种程度上使用的术语)也取决于上下文,但在实施QDM时,该组中的讨论会蒸馏出要考虑的共同原理,尤其是围绕QDM框架的构建,评估操作特征和与临床团队的沟通。本手稿提出了要考虑的观点,希望它们对有兴趣实施QDM的统计学家有帮助。
Quantitative decision-making (QDM) principles address the issues related to the mapping of results to decisions, the synthesis of information and the quantification of uncertainty. Since the clinical drug development involves a succession of decisions to be made, QDM methods can be applied at various levels. At the study level, it can be used to properly design a study, and improve the decisions that are made either during the trial or at its end. Establishing decision criteria ahead of the study is essential here to address the need for speedy decisions, potentially in real time. At the project level, QDM can be used to inform decisions to continue, adapt or stop a drug development programme based on results from previous studies. At the portfolio level, QDM can be used to choose, prioritise and optimise the development portfolio, e.g. using the probability to reach market access or target sales within a predefined timeline. The increasing interest in QDM and its statistical nature led in 2017 to the development a cross-industry and academia Special Interest Group on QDM within the Society and the European Federation of Statisticians in the Pharmaceutical Industry (PSI and EFSPI). The activities of the group included discussing QDM examples, some published in the literature and some real anonymised ones covering several settings. While the methodologies, and to some extent the terminology, employed also varied depending on the context, discussions within the group distilled common principles to be considered when implementing QDM, particularly around the construction of QDM frameworks, assessment of operating characteristics and communication with the clinical team. The present manuscript presents those points to consider, hoping they can be helpful to statisticians interested in implementing QDM.