Monday, October 02, 2017 12:13:33 PM
Info on how a phase 2b is different from a phase 2 and how the "pivot" works:
"Using decision theory, Gilbert outlines how to effectively surmise one of five decisions at the end of a phase 2B trial: (i) treatment is harmful, (ii) treatment is useless, (iii) treatment is plausible and a phase 3 trial should be conducted, (iv) treatment meets phase 3 criteria for efficacy, or (v) treatment meets criteria for efficacy from two phase 3 trials.
The decision theory framework is the mathematical formula that allows the study team to place weights as to the importance of each of the above five concepts in determining a study outcome while still arriving at a single decision on the basis of the size of the effect of the treatment in the study. This makes decision theory no more difficult to interpret than interpreting a P value above or below 0.05. Using this study design framework, Gilbert theorizes that moving to a phase 3 study from a phase 2 study is only warranted when the pre-test plausibility of treatment success is extremely high. This work establishes the role that phase 2B studies can play in moving more treatments from the bench to final clinical testing in humans and shows how decision theory can be used to expand the considerations included in a studies design."
from Phase 2B Clinical Trials—A Useful Interim Step to a Phase 3 Clinical Trial
http://stm.sciencemag.org/content/2/31/31ec76
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