A Proposal for Integrated Efficacy-to-Effectiveness (E2E) Clinical Trials
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Oye_A proposal.pdf
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234.57 KB
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Author(s)
Selker, H. P.
Eichler, H.-G.
Stockbridge, N. L.
Mehta, C. R.
Kaitin, K. I.
McElwee, N. E.
Honig, P. K.
Erban, J. K.
D’Agostino, R. B.
Oye, Kenneth A.
Date Issued
September 2013
Journal
Clinical Pharmacology & Therapeutics
Publisher
Wiley Blackwell
Citation
Selker, H P, K A Oye, H-G Eichler, N L Stockbridge, C R Mehta, K I Kaitin, N E McElwee, P K Honig, J K Erban, and R B D’Agostino. “A Proposal for Integrated Efficacy-to-Effectiveness (E2E) Clinical Trials.” Clinical Pharmacology & Therapeutics 95, no. 2 (September 23, 2013): 147–153.
Version
Final published version
Abstract
We propose an “efficacy-to-effectiveness” (E2E) clinical trial design, in which an effectiveness trial would commence seamlessly upon completion of the efficacy trial. Efficacy trials use inclusion/exclusion criteria to produce relatively homogeneous samples of participants with the target condition, conducted in settings that foster adherence to rigorous clinical protocols. Effectiveness trials use inclusion/exclusion criteria that generate heterogeneous samples that are more similar to the general patient spectrum, conducted in more varied settings, with protocols that approximate typical clinical care. In E2E trials, results from the efficacy trial component would be used to design the effectiveness trial component, to confirm and/or discern associations between clinical characteristics and treatment effects in typical care, and potentially to test new hypotheses. An E2E approach may improve the evidentiary basis for selecting treatments, expand understanding of the effectiveness of treatments in subgroups with particular clinical features, and foster incorporation of effectiveness information into regulatory processes.
MIT Department
Massachusetts Institute of Technology. Department of Political Science
Massachusetts Institute of Technology. Engineering Systems Division
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Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License
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DOI of Published Version
https://doi.org/10.1038/clpt.2013.177
