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Ferstad JO, Prahalad P, Maahs DM, Zaharieva DP, Fox E, Desai M, Johari R, Scheinker D. Smart Start - Designing Powerful Clinical Trials Using Pilot Study Data. NEJM EVIDENCE 2024; 3:EVIDoa2300164. [PMID: 38320487 DOI: 10.1056/evidoa2300164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
BACKGROUND: Digital health interventions may be optimized before evaluation in a randomized clinical trial. Although many digital health interventions are deployed in pilot studies, the data collected are rarely used to refine the intervention and the subsequent clinical trials. METHODS: We leverage natural variation in patients eligible for a digital health intervention in a remote patient-monitoring pilot study to design and compare interventions for a subsequent randomized clinical trial. RESULTS: Our approach leverages patient heterogeneity to identify an intervention with twice the estimated effect size of an unoptimized intervention. CONCLUSIONS: Optimizing an intervention and clinical trial based on pilot data may improve efficacy and increase the probability of success. (Funded by the National Institutes of Health and others; ClinicalTrials.gov number, NCT04336969.)
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Affiliation(s)
- Johannes O Ferstad
- Department of Management Science and Engineering, Stanford University School of Engineering, Stanford, CA
| | - Priya Prahalad
- Division of Pediatric Endocrinology, Stanford University School of Medicine, Stanford, CA
| | - David M Maahs
- Division of Pediatric Endocrinology, Stanford University School of Medicine, Stanford, CA
| | - Dessi P Zaharieva
- Division of Pediatric Endocrinology, Stanford University School of Medicine, Stanford, CA
| | - Emily Fox
- Department of Statistics, Stanford University, Stanford, CA
- Department of Computer Science, Stanford University, Stanford, CA
- Chan Zuckerberg Biohub, San Francisco
| | - Manisha Desai
- Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Ramesh Johari
- Department of Management Science and Engineering, Stanford University School of Engineering, Stanford, CA
| | - David Scheinker
- Department of Management Science and Engineering, Stanford University School of Engineering, Stanford, CA
- Division of Pediatric Endocrinology, Stanford University School of Medicine, Stanford, CA
- Clinical Excellence Research Center, Stanford University School of Medicine, Stanford, CA
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Christian BJ. Translational research - Universal parenting challenges and coping with change. J Pediatr Nurs 2023; 69:123-126. [PMID: 37061254 PMCID: PMC10097610 DOI: 10.1016/j.pedn.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Affiliation(s)
- Becky J Christian
- School of Nursing, The University of Kansas, Kansas City, Kansas, USA.
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