Journal Article

Use of a Bayesian Approach to Decide When to Stop a Therapeutic Trial: The Case of a Chemoprophylaxis Trial in Human Immunodeficiency Virus Infection

Alphonse Kpozèhouen, Ahmadou Alioum, Xavier Anglaret, Philippe Van de Perre, Geneviève Chêne and Roger Salamon

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 161, issue 6, pages 595-603
Published in print March 2005 | ISSN: 0002-9262
Published online March 2005 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwi065
Use of a Bayesian Approach to Decide When to Stop a Therapeutic Trial: The Case of a Chemoprophylaxis Trial in Human Immunodeficiency Virus Infection

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From 1996 to 1998, a phase III, placebo-controlled, therapeutic trial was conducted in Abidjan, Ivory Coast, to assess the efficacy of cotrimoxazole prophylaxis in reducing severe morbidity in adults at early stages of human immunodeficiency virus infection. The authors used the real data from this trial to simulate three Bayesian interim analyses. Three prior distributions were considered: a noninformative one, a skeptical one, and one based on external information. The posterior distribution was calculated by using directed acyclic graphs and Gibbs sampling. This Bayesian approach showed different results according to the prior distribution chosen. Although use of the noninformative prior would have led to stopping the trial at the same time that the frequentist approach would have, the skeptical prior would have led to continuing it, and the prior based on external data would have led to stopping it 1 year earlier.

Keywords: Bayesian approach; cotrimoxazole; counting process; Cox model; directed acyclic graph; Gibbs sampling; ANRS    Agence Nationale de Recherche sur le Sida; CI    Côte d'Ivoire; HIV    human immunodeficiency virus

Journal Article.  4981 words.  Illustrated.

Subjects: Public Health and Epidemiology

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