Dose‐finding is an important part of the clinical development of a new drug. The purpose of dose‐finding studies is to determine a suitable dose for future development based on both efficacy and safety. Optimal experimental designs have already been used to determine the design of this kind of studies, however, often that design is focused on efficacy only. We consider an efficacy–safety model, which is a simplified version of the bivariate Emax model. We use here the clinical utility index concept, which provides the desirable balance between efficacy and safety. By maximizing the utility of the patients, we get the estimated dose. This desire leads us to locally boldc‐optimal designs. An algebraic solution for boldc‐optimal designs is determined for arbitrary boldc vectors using a multivariate version of Elfving's method. The solution shows that the expected therapeutic index of the drug is a key quantity determining both the number of doses, the doses itself, and their weights in the optimal design. A sequential design is proposed to solve the complication of parameter dependency, and it is illustrated in a simulation study.
Much of classical optimal design theory relies on specifying a model with only a small number of parameters. In many applications, such models will give reasonable approximations. However, they will often be found not to be entirely correct when enough data are at hand. A property of classical optimal design methodology is that the amount of data does not influence the design when a fixed model is used. However, it is reasonable that a low dimensional model is satisfactory only if limited data is available. With more data available, more aspects of the underlying relationship can be assessed. We consider a simple model that is not thought to be fully correct. The model misspecification, that is, the difference between the true mean and the simple model, is explicitly modeled with a stochastic process. This gives a unified approach to handle situations with both limited and rich data. Our objective is to estimate the combined model, which is the sum of the simple model and the assumed misspecification process. In our situation, the low-dimensional model can be viewed as a fixed effect and the misspecification term as a random effect in a mixed-effects model. Our aim is to predict within this model. We describe how we minimize the prediction error using an optimal design. We compute optimal designs for the full model in different cases. The results confirm that the optimal design depends strongly on the sample size. In low-information situations, traditional optimal designs for models with a small number of parameters are sufficient, while the inclusion of the misspecification term lead to very different designs in data-rich cases.
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