Simulation optimization for Bayesian multi-arm multi-stage clinical trial with binary endpoints

J Biopharm Stat. 2019;29(2):306-317. doi: 10.1080/10543406.2019.1577682. Epub 2019 Feb 14.


Multi-arm multi-stage designs, in which multiple active treatments are compared to a control and accumulated information from interim data are used to add or remove arms from the trial, may reduce development costs and shorten the drug development timeline. As such, this adaptive update is a natural complement to Bayesian methodology in which the prior clinical belief is sequentially updated using the observed probability of success. Simulation is often required for planning clinical trials to accommodate the complexity of the design and to optimize key design characteristics. This paper addresses two key limiting factors in simulations, namely the computational burden and the time needed to obtain results. We first introduce a generic process for simulating Bayesian multi-arm multi-stage designs with binary endpoints. Then, to address the computational burden and time, we optimize the method for calculating the posterior probability and posterior predictive probability of success.

Keywords: Bayesian; clinical trial; multi-arm multi-stage design; simulation.

MeSH terms

  • Bayes Theorem
  • Benchmarking
  • Clinical Trials as Topic / methods*
  • Clinical Trials as Topic / statistics & numerical data
  • Computer Simulation*
  • Endpoint Determination / statistics & numerical data*
  • Humans
  • Models, Statistical*
  • Neuroprotective Agents / administration & dosage
  • Neuroprotective Agents / therapeutic use
  • Probability
  • Research Design / statistics & numerical data*
  • Stroke / drug therapy
  • Treatment Outcome


  • Neuroprotective Agents