Platform trials gained popularity during the last few years as they increase flexibility compared to multi-arm trials by allowing new experimental arms entering when the trial already started. Using a shared control group in platform trials increases the trial efficiency compared to separate trials. Because of the later entry of some of the experimental treatment arms, the shared control group includes concurrent and non-concurrent control data. For a given experimental arm, non-concurrent controls refer to patients allocated to the control arm before the arm enters the trial, while concurrent controls refer to control patients that are randomised concurrently to the experimental arm. Using non-concurrent controls can result in bias in the estimate in case of time trends if the appropriate methodology is not used and the assumptions are not met. In this paper, we faced two main objectives. In the first, we aimed to identify the methods currently available for incorporating non-concurrent controls, clarify the key concepts and assumptions, and name the main characteristics of each method. For this purpose, we systematically searched research articles on methods to include non-concurrent controls. The second objective is to summarise the current regulatory view on non-concurrent controls to clarify the key concepts and current guidance. Therefore, we conducted a systematic search in regulatory guidelines regarding using non-concurrent controls and summarised the most relevant arguments and recommended methods. Finally, we discuss the advantages and potential caveats of using non-concurrent controls.
翻译:与多武器试验相比,平台试验在过去几年中越来越受欢迎,因为与多武器试验相比,这些试验增加了灵活性,因为在试验已经开始时允许新的试验性武器进入试验。在平台试验中使用一个共同控制小组,提高了试验效率,与单独试验相比。由于一些实验性处理武器较晚进入,共同控制小组包括同时和非连续的控制数据。对于特定的实验性手臂,非连续控制是指在试验性手臂进入试验前分配给控制手臂的病人,而同时控制是指随机进入试验性手臂的病人。在不使用适当方法、不满足假设的情况下,在时间趋势的估计中可能会产生偏差。在本文件中,我们面临两个主要目标。首先,我们旨在确定目前可用于纳入非连续控制的方法,澄清关键概念和假设,并列出每种方法的主要特点。为此目的,我们系统地搜索关于方法的研究文章,将非连续控制包括在内。第二个目标是总结目前关于非动态控制的管理观点,以澄清关键概念和当前指导没有实现。因此,我们使用不连续控制的方法进行系统搜索。最后,我们使用不连续的争论。