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Background: Recently, several adaptive one-arm two-stage designs have been developed by fully using the information from previous stages to reduce the expected sample size in clinical trials with binary endpoints as primary outcome. It is important to compute exact confidence limits for these studies.Methods: In this article, we propose three new one-sided limits by ordering the sample space based on p-value, average response rate at each stage, and asymptotic lower limit, as compared to another three existing sample size ordering approaches based on average response rate. Among the three proposed approaches, the one based on the average response rate at each stage is not exact, and the remaining two approaches are exact with the coverage probability guaranteed.Results: We compare these exact intervals by using the two commonly used criteria: simple average length and expected length. The existing three approaches based on average response rate have similar performance, and they have shorter expected lengths than the two proposed exact approaches although the gain is small, while this trend is reversed under the simple average criterion.Conclusions: We would recommend the two exact proposed approaches based on p-value and asymptotic lower limit under the simple average length criterion, and the approach based on average response rate under the expected length criterion. [ABSTRACT FROM AUTHOR]

Background: Simon's two-stage design is the most widely implemented among multi-stage designs in phase II clinical trials to assess the activity of a new treatment in a single-arm study. In this two-stage design, the sample size from the second stage is fixed regardless of the number of responses observed in the first stage.Methods: We develop a new minimax adaptive design for phase II clinical trials, by using the branch-and-bound intelligent algorithm based on conditional error functions.Results: We compare the performance of the proposed design and competitors, including Simon's minimax design, and a modified Simon's design that allows early stopping for futility or efficacy. The maximum sample size of the proposed minimax adaptive design is guaranteed to be less than or equal to those from other existing designs. When the proposed design has the same maximum sample size as others, it always has the smallest expected sample size. In addition to the minimax adaptive design, we also introduce admissible adaptive designs determined from a Bayesian perspective.Conclusions: The proposed adaptive minimax design can save sample sizes for a clinical trial. The minimum required sample size is critical to reduce the cost of a project. [ABSTRACT FROM AUTHOR]

Background: Recently, several adaptive one-arm two-stage designs have been developed by fully using the information from previous stages to reduce the expected sample size in clinical trials with binary endpoints as primary outcome. It is important to compute exact confidence limits for these studies., Methods: In this article, we propose three new one-sided limits by ordering the sample space based on p-value, average response rate at each stage, and asymptotic lower limit, as compared to another three existing sample size ordering approaches based on average response rate. Among the three proposed approaches, the one based on the average response rate at each stage is not exact, and the remaining two approaches are exact with the coverage probability guaranteed., Results: We compare these exact intervals by using the two commonly used criteria: simple average length and expected length. The existing three approaches based on average response rate have similar performance, and they have shorter expected lengths than the two proposed exact approaches although the gain is small, while this trend is reversed under the simple average criterion., Conclusions: We would recommend the two exact proposed approaches based on p-value and asymptotic lower limit under the simple average length criterion, and the approach based on average response rate under the expected length criterion.

Background: Simon's two-stage design is the most widely implemented among multi-stage designs in phase II clinical trials to assess the activity of a new treatment in a single-arm study. In this two-stage design, the sample size from the second stage is fixed regardless of the number of responses observed in the first stage., Methods: We develop a new minimax adaptive design for phase II clinical trials, by using the branch-and-bound intelligent algorithm based on conditional error functions., Results: We compare the performance of the proposed design and competitors, including Simon's minimax design, and a modified Simon's design that allows early stopping for futility or efficacy. The maximum sample size of the proposed minimax adaptive design is guaranteed to be less than or equal to those from other existing designs. When the proposed design has the same maximum sample size as others, it always has the smallest expected sample size. In addition to the minimax adaptive design, we also introduce admissible adaptive designs determined from a Bayesian perspective., Conclusions: The proposed adaptive minimax design can save sample sizes for a clinical trial. The minimum required sample size is critical to reduce the cost of a project.