A new futility test approach in clinical interim data monitoring

Sequential monitoring of efficacy and safety data has become a vital component of modern clinical trials. It affords companies the opportunity to stop studies early in cases when it appears as if the primary objective will not be achieved or when there is clear evidence that the primary objective has already been met. This paper introduces a new concept of the backward conditional hypothesis test (BCHT) to evaluate clinical trial success. Unlike the regular conditional power approach that relies on the probability that the final study result will be statistically significant based on the current interim look, the BCHT was constructed based on the hypothesis test framework. The framework comprises a significant test level as opposed to the arbitrary fixed futility index utilized in the conditional power method. Additionally, the BCHT has proven to be a uniformly most powerful test. Noteworthy features of the BCHT method compared with the conditional power method will be presented. Copyright © 2012 John Wiley & Sons, Ltd.