A Discussion with Michael Proschan on Response-Adaptive Randomization

In this episode of "In the Interim…", Dr. Scott Berry and NIH’s Dr. Michael Proschan conduct a detailed discussion from opposing viewpoints on response-adaptive randomization (RAR) in clinical trials. The discussion focuses on where they agree – on the positives and negatives of RAR, and where they disagree on its scientific use.

Key Highlights

• Potential issues of using RAR: Potential temporal trends, unblinding, reduction in statistical efficiency in 2-arm trials
• Potential benefits include improved statistical efficiency in multi-arm trials  depending on the goals (e.g. dose-finding trials).
• Potential unblinding of results in non-blinded trials and the need for operational excellence.
• Ethical and Bayesian perspectives are considered, but emphasis remains empirical.

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