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12 September 2024

PSI Journal Club presents “Subgroup and Covariate Analysis”. Chaired by Chris Harbron with presentations from: Thomas Jemielita: - Investigating Stability in Subgroup Identification for Stratified Medicine and Björn Holzhauer: - “Super-covariates”: Using predicted control group outcome as a covariate in randomized clinical trials.

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PSI Journal Club presents “Subgroup and Covariate Analysis”. Chaired by Chris Harbron with presentations from: Thomas Jemielita: - Investigating Stability in Subgroup Identification for Stratified Medicine and Björn Holzhauer: - “Super-covariates”: Using predicted control group outcome as a covariate in randomized clinical trials.

11 September 2024

Many cancer trials use the progression free survival as primary outcome measure, i.e. the length of time that a patient lives on without worsening of the disease. Various reasons can lead to censoring of the data. And differential censoring could influence the interpretation of the results. Paolo Eusebi presents visualisations that help to explore the pattern of events and reasons for censoring. Visualisations are available on the Wonderful Wednesday blog.

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Many cancer trials use the progression free survival as primary outcome measure, i.e. the length of time that a patient lives on without worsening of the disease. Various reasons can lead to censoring of the data. And differential censoring could influence the interpretation of the results. Paolo Eusebi presents visualisations that help to explore the pattern of events and reasons for censoring. Visualisations are available on the Wonderful Wednesday blog.

The basic plot for progression free survival is the survival plot using Kaplan-Meier estimates. Augmented with information on censoring this gives a great overview. An innovative way of displaying events and censoring is by stacked lollipop plot. See the panel discussing pros and cons. The next challenge is about visualising dose response in subgroups for personalized dosing. See the Wonderful Wednesday homepage for more detail.

Wonderful Wednesdays are brought to you by the Visualisation SIG. The Wonderful Wednesday team includes: Bodo Kirsch, Zachary Skrivanek, Lorenz Uhlmann, Steve Mallett, Rhys Warham, Mark Baillie, Paolo Eusebi, Martin Brown, Benjamin Lang

14 August 2024

The development of a new patient reported outcome (PRO) needs to include the interpretation of the results. It should be possible to define a minimal clinically important difference and a meaningful between-group difference. Rhys Warham is presenting ways how visualisations can support that process. They are available on the Wonderful Wednesday blog.

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The development of a new patient reported outcome (PRO) needs to include the interpretation of the results. It should be possible to define a minimal clinically important difference and a meaningful between-group difference. Rhys Warham is presenting ways how visualisations can support that process. They are available on the Wonderful Wednesday blog.

For comparing the new PRO with the gold standard eCDF plots and PDF plots can be shown overlapping or stacked. There are also many different ways to show the distribution of within the standard ratings to easily spot differences or possible inconsistencies. The next challenge is on the event pattern in a study aiming for improvement on progression free survival. See the Wonderful Wednesday homepage for more detail.

Wonderful Wednesdays are brought to you by the Visualisation SIG. The Wonderful Wednesday team includes: Bodo Kirsch, Zachary Skrivanek, Lorenz Uhlmann, Steve Mallett, Rhys Warham, Mark Baillie, Paolo Eusebi, Martin Brown, Benjamin Lang


07 August 2024

This webinar will help listeners gain a broader understanding of a recent and rapidly advancing core area of pharmaceutical drug development. The content will be broad, but will focus on clinical design and analysis strategies for advanced therapeutics such as cell/gene therapies, and strategic options to advance candidate drugs in this space.

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Avery McIntosh (Pfizer) and Oleksandr Sverdlov (Novartis)

This webinar will help listeners gain a broader understanding of a recent and rapidly advancing core area of pharmaceutical drug development. The content will be broad, but will focus on clinical design and analysis strategies for advanced therapeutics such as cell/gene therapies, and strategic options to advance candidate drugs in this space.

One of the recent advances in 21st century medicine is the emergence of gene therapies, drugs that affect the basic biology of genetic disease. The field has seen some notable setbacks in the past, but in recent years has exploded as decades of basic science have been successfully translated into the most complex biologics ever constructed, leading to regulatory approval of several gene therapy products in oncology, hematology, neurology, and ophthalmology indications. These drugs are at the apex of biological manufacturing complexity, and have the potential to be disease modifying or even curative. Evidence-based and innovative quantitative clinical development and lifecycle management strategies will be required as fixtures in the development for these unique drugs in order to reach patients in need. In this webinar we provide an overview of the history and future of gene therapies, and discuss the crucial role of the statistician in the drug development process of these drugs, with a focus on innovative trial design and analysis techniques.

A list of useful references from the presentation can be found below:
- McIntosh, Avery, and Oleksandr Sverdlov, eds. Development of Gene Therapies: Strategic, Scientific, Regulatory, and Access Considerations. CRC Press, 2024.
- Rohde, Maximilian, et al. "Practical and Statistical Considerations for the Long Term Follow‐Up of Gene Therapy Trial Participants." Clinical Pharmacology & Therapeutics 115.1 (2024): 139-146.
- McIntosh, Avery, et al. "Clinical design and analysis strategies for the development of gene therapies: considerations for quantitative drug development in the age of genetic medicine." Clinical Pharmacology & Therapeutics 110.5 (2021): 1207-1215.
- Mueller, Arne, et al. "Digital endpoints for self‐administered home‐based functional assessment in pediatric Friedreich’s ataxia." Annals of Clinical and Translational Neurology 8.9 (2021): 1845-1856.
- Hudry, Eloise, and Luk H. Vandenberghe. "Therapeutic AAV gene transfer to the nervous system: a clinical reality." Neuron 101.5 (2019): 839-862.
- Cox, Gerald F. "The art and science of choosing efficacy endpoints for rare disease clinical trials." American Journal of Medical Genetics Part A 176.4 (2018): 759-772

10 July 2024

This webinar follows up on last month's challenge on platform trial design. This time the impact of specific design changes is highlighted with effective visualisations. Bodo Kirsch is presenting examples for exploratory and explanatory visualisations. They are available on the Wonderful Wednesday blog.

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This webinar follows up on last month's challenge on platform trial design. This time the impact of specific design changes is highlighted with effective visualisations. Bodo Kirsch is presenting examples for exploratory and explanatory visualisations. They are available on the Wonderful Wednesday blog.

Exploring a huge variety of possible scenarios can be tedious. Exploratory visualisations can improve that process dramatically by using interactive parameter setting. That's what the two shiny apps of today's webinar do. Once an effect has been explored an explanatory visualisation is a powerful tool to communicate this. The next challenge is about responder definition. See the Wonderful Wednesday homepage for more detail.


Wonderful Wednesdays are brought to you by the Visualisation SIG. The Wonderful Wednesday team includes: Bodo Kirsch, Zachary Skrivanek, Lorenz Uhlmann, Steve Mallett, Rhys Warham, Mark Baillie, Paolo Eusebi, Martin Brown, Benjamin Lang.


02 July 2024

We will review how the Graduate study team interpreted the estimand framework and used its elements to cover the primary clinical question of interest. We will review the challenges we met and the solutions we implemented.

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Rachid Abbas, Angeliki Thanaspoulou, Marcel Wolbers

GRADUATE I(NCT03444870) and GRADUATE II (NCT03443973) were two global, Phase III, randomized, placebo-controlled trials assessing the efficacy and safety of gantenerumab in early Alzheimer’s disease. The GRADUATE studies were among the first pivotal trials in Alzheimer’s Disease to adopt the estimand framework and to conduct a primary analysis which is fully aligned with the targeted estimand. In this webinar we will review the key elements of the estimand framework through the experience of the Graduate study team. We will review how the Graduate study team interpreted the estimand framework and used its elements to cover the primary clinical question of interest. We will review the challenges we met and the solutions we implemented.

18 June 2024

1. Alessandra Serra 2. Andisheh Bakhshi 3. Daniel Clement 4. Luca Rondano 5. Marco Ratta

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Alessandra Serra, Andisheh Bakhshi, Daniel Clement, Luca Rondano, Marco Ratta

17 June 2024

Theo will guide us through the multifaceted world of neurodiversity. You will gain insights into: • The essence of Neurodiversity, an understanding of the spectrum of cognitive differences • The crucial Terminology that frames our conversations around it • Why Neurodiversity is a Hot Topic in today’s fast-evolving corporate landscape, • The Advantages of Neurodiverse Teams, where cognitive diversity can be a catalyst for creativity and efficiency • Strategies on How to Harness the Best from Team Members, fostering an environment where every individual thrives • The Challenges we face and how to navigate them with empathy and intelligence • Envisioning The Future of Neurodiversity in the workplace, where potential is not just recognised but celebrated and cultivated • And lastly, an interactive Panel Session, fostering a dialogue that sparks change Prepare to embark on a journey that challenges the status quo, embraces the power of diversity, and leads us toward a more inclusive and innovative future. Let's open our minds to the rich diversity of human thought as Theo Smith takes the stage.

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Theo Smith

Theo will guide us through the multifaceted world of neurodiversity. You will gain insights into:
• The essence of Neurodiversity, an understanding of the spectrum of cognitive differences • The crucial Terminology that frames our conversations around it
• Why Neurodiversity is a Hot Topic in today’s fast-evolving corporate landscape
• The Advantages of Neurodiverse Teams, where cognitive diversity can be a catalyst for creativity and efficiency
• Strategies on How to Harness the Best from Team Members, fostering an environment where every individual thrives
• The Challenges we face and how to navigate them with empathy and intelligence
• Envisioning The Future of Neurodiversity in the workplace, where potential is not just recognised but celebrated and cultivated
• And lastly, an interactive Panel Session, fostering a dialogue that sparks change.

Prepare to embark on a journey that challenges the status quo, embraces the power of diversity, and leads us toward a more inclusive and innovative future. Let's open our minds to the rich diversity of human thought as Theo Smith takes the stage.

17 June 2024

This session will cover the topic of decision making in clinical trials. One talk will discuss the use of quantitative decision making in designing trials and how it can outline inherent risk with a study design. Another talk will discuss assurance methods for survival trials with a delayed treatment effect in a Phase 3 oncology setting and present elicitation techniques on how to compute assurance. The third talk introduces the concept of "Detriment Index" as a novel ranking technique for drugs in the context of the management of pain in individuals with noncommunicable diseases, offering a comprehensive and evidence-based method for healthcare providers, researchers, and policymakers to evaluate and prioritize pain management strategies.

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Gaelle Saint-Hilary, Rosalind Hobson, Wei Quan

This session will cover the topic of decision making in clinical trials. One talk will discuss the use of quantitative decision making in designing trials and how it can outline inherent risk with a study design. Another talk will discuss assurance methods for survival trials with a delayed treatment effect in a Phase 3 oncology setting and present elicitation techniques on how to compute assurance. The third talk introduces the concept of "Detriment Index" as a novel ranking technique for drugs in the context of the management of pain in individuals with noncommunicable diseases, offering a comprehensive and evidence-based method for healthcare providers, researchers, and policymakers to evaluate and prioritize pain management strategies.

17 June 2024

With the centralized European Joint Clinical Assessment, Indirect Treatment Comparisons (ITCs) will play an integral role to show comparative evidence versus the national standard of care(s). Latest developments in ITC methodology on adjustment for measured and unmeasured confounding in ITCs and bias quantification will be presented in this session.

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HTA ESIG

With the centralized European Joint Clinical Assessment, Indirect Treatment Comparisons (ITCs) will play an integral role to show comparative evidence versus the national standard of care(s). Latest developments in ITC methodology on adjustment for measured and unmeasured confounding in ITCs and bias quantification will be presented in this session.

17 June 2024

Adaptive designs and complex clinical trials offer many well-known advantages throughout the clinical development process and their acceptance is steadily increasing. Typically, such designs use either the Bayesian or the frequent framework for decision making and reporting. While frequentist adaptive designs often have closed-form calculations of operating characteristics, Bayesian designs usually require simulations. On the other hand, Bayesian designs often make it easy to communicate results, incorporate multiple endpoints and achieve efficiency gains by using e.g., the predictive probability for interim decision making. Regardless of the choice of analysis method and the associated philosophical differences in the paradigms, there is an understanding that, among others, frequentist operating characteristics such as power and type 1 error are important to evaluate the proposed design. Ultimately, both Bayesian and frequentist adaptive designs aim to and should be judged by their ability to produce better and more efficient clinical trials without compromising their statistical integrity. In this session, we will bring together experts in the design of both Bayesian and frequentist adaptive trials, as well as a senior European regulator to learn more about recent methodological advances, regulatory considerations, and practical experiences when designing and assessing these trial designs

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Cora Allen-Savietta, Franz Konig, Benjamin Hofner

Adaptive designs and complex clinical trials offer many well-known advantages throughout the clinical development process and their acceptance is steadily increasing. Typically, such designs use either the Bayesian or the frequent framework for decision making and reporting. While frequentist adaptive designs often have closed-form calculations of operating characteristics, Bayesian designs usually require simulations. On the other hand, Bayesian designs often make it easy to communicate results, incorporate multiple endpoints and achieve efficiency gains by using e.g., the predictive probability for interim decision making. Regardless of the choice of analysis method and the associated philosophical differences in the paradigms, there is an understanding that, among others, frequentist operating characteristics such as power and type 1 error are important to evaluate the proposed design. Ultimately, both Bayesian and frequentist adaptive designs aim to and should be judged by their ability to produce better and more efficient clinical trials without compromising their statistical integrity. In this session, we will bring together experts in the design of both Bayesian and frequentist adaptive trials, as well as a senior European regulator to learn more about recent methodological advances, regulatory considerations, and practical experiences when designing and assessing these trial designs

17 June 2024

Adaptive designs and complex clinical trials offer many well-known advantages throughout the clinical development process and their acceptance is steadily increasing. Typically, such designs use either the Bayesian or the frequent framework for decision making and reporting. While frequentist adaptive designs often have closed-form calculations of operating characteristics, Bayesian designs usually require simulations. On the other hand, Bayesian designs often make it easy to communicate results, incorporate multiple endpoints and achieve efficiency gains by using e.g., the predictive probability for interim decision making. Regardless of the choice of analysis method and the associated philosophical differences in the paradigms, there is an understanding that, among others, frequentist operating characteristics such as power and type 1 error are important to evaluate the proposed design. Ultimately, both Bayesian and frequentist adaptive designs aim to and should be judged by their ability to produce better and more efficient clinical trials without compromising their statistical integrity. In this session, we will bring together experts in the design of both Bayesian and frequentist adaptive trials, as well as a senior European regulator to learn more about recent methodological advances, regulatory considerations, and practical experiences when designing and assessing these trial designs.

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Suzanne Schaefer, Mia Tackey, Rosemary Abbott

Adaptive designs and complex clinical trials offer many well-known advantages throughout the clinical development process and their acceptance is steadily increasing. Typically, such designs use either the Bayesian or the frequent framework for decision making and reporting. While frequentist adaptive designs often have closed-form calculations of operating characteristics, Bayesian designs usually require simulations. On the other hand, Bayesian designs often make it easy to communicate results, incorporate multiple endpoints and achieve efficiency gains by using e.g., the predictive probability for interim decision making. Regardless of the choice of analysis method and the associated philosophical differences in the paradigms, there is an understanding that, among others, frequentist operating characteristics such as power and type 1 error are important to evaluate the proposed design. Ultimately, both Bayesian and frequentist adaptive designs aim to and should be judged by their ability to produce better and more efficient clinical trials without compromising their statistical integrity. In this session, we will bring together experts in the design of both Bayesian and frequentist adaptive trials, as well as a senior European regulator to learn more about recent methodological advances, regulatory considerations, and practical experiences when designing and assessing these trial designs.

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