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Proof of concept
 

The PACE Initiative intends to launch a “Proof of Concept” study to determine the degree to which a Bayesian adaptive trial design could be more efficient, saving money and time. Specifically, our intention is to a) select a completed comparative effectiveness trial; b) go back in time under a “veil of ignorance”; c) develop a full Bayesian prior via, e.g. a systematic review of available evidence including a multiple treatment comparisons (MTCs) analysis, from which to; d) create a Bayesian adaptive trial design; e) develop a full simulation model of the proposed trial; f) obtain the actual data from the completed trial; f) populate the simulation as if the trial were running to determine/demonstrate the adaptation process that could/would have occurred; and g) compare the two approaches in terms of trial design, execution, timeline, cost and possibly outcomes. A nationally-prominent, independent clinical/statistical-analytical/policy advisory board would be appointed to oversee the integrity of the project. Timeline: completion in 12 months.

 
 

The PACE Initiative Inaugural Sponsor Advisory Council meeting

 

Announcing the Inaugural PACE Initiative Sponsor Advisory Council Meeting held on Friday, September 25, 2009. PACE Initiative Sponsor Advisory Council Documents:

 
 

New Publication

 

Announcing a new publication based on the Invitational Forum "New Approaches to Clinical Trials: Implications for Comparative Effectiveness":

Luce BR, Kramer JM, Goodman SN, Conner J, Tunis S, Whicher D, Schwartz JS. Rethinking Randomized Clinical Trials for Comparative Effectiveness Research: The Need for Transformational Change. Annals of Internal Medicine. 4 August 2009;151(3).(Available Online)

 

 
 

The PACE Initiative Launches Stage Two

 
 

After a successful pilot year of PACE Initiative activity, Stage Two launches the newest venture to include both corporate and non-corporate sponsors as full PACE Initiative members with the aim of providing each the opportunity to help shape the comparative effectiveness research policy agenda as it unfolds within both the private and public sectors in the US and, at a later time, possibly internationally. This critical stage will provide sponsors a focused forum to discuss, debate, guide, and possibly resolve or adopt important science, policy, and business issues relative to comparative effectiveness trial research. 

Stage One

In January, 2008, UBC launched Stage One of an ambitious effort termed the PACE (Pragmatic Approaches to Comparative Effectiveness) Initiative.  The initial stage was intended to contribute to the national dialogue about comparative effectiveness research.  Specifically, the PACE Initiative endeavors to stimulate novel, pragmatic solutions for clinical study designs in comparative effectiveness trial applications.  These novel concepts include trial simulation; adaptive techniques including integrated, sequential, and Bayesian statistical methods; pragmatic clinical trial designs; and, large simple trials. It is the contention of the PACE Initiative that without true transformational re-thinking in the design and operation of comparative effectiveness trial methods, the private and public sectors risk wasting vast amounts of money answering the wrong questions, or the right questions too late, thereby lessening the opportunity to achieve the ambitious objectives of improving the quality and cost efficiency of health care.

First year accomplishments included convening an Advisory Board, securing corporate sponsorship, developing and launching a website, hosting seminars and forums, recruiting scientific staff, initiating a working paper series, nurturing collaborative relationships, and providing advisement to federal policymakers.

For a transformation to occur, however, a number of policy, analytical, and operational issues need to be identified, tested, resolved, communicated, and, as appropriate, adopted.  The PACE Initiative is committed to facilitating such a transformation by functioning as a catalyst for responsible change in related policies and engaging in research activities to foster responsible methods such that CER trials are useful, feasible, efficient, and pragmatic.

Stage Two

In Stage Two, PACE Initiative members will play a vital role in guiding the Initiative’s agenda and resulting activities.  We anticipate that the features and offerings of membership will grow and/or change over time as membership grows and the needs and interests of the PACE Initiative Sponsor’s Advisory Council (PSAC) develop and are expressed.  Membership offerings will include:

  • participation in the PACE Initiative Sponsor Advisory Council (PSAC);

  • opportunities to sponsor and/or contribute to (including possible co-authorship) the PACE Initiative Working Paper Series;

  • regular updates on CER trial-related issues;

  • outreach opportunities.

Each of these offerings will provide PACE Initiative members with an active, hands-on substantive role in crafting realistic and innovative approaches and solutions to some of the most pressing national research questions.  

Finally, an additional, albeit more intangible, benefit of being a PACE Initiative member is access to PACE staff who will be increasingly knowledgeable about CER trial state-of-the-art, state-of-information, state of activity, and who will maintain working relationships with other related organizations and key opinion leaders associated with this dynamic, clinical, business and policy relevant field.  

For more information, or to discuss specific membership interests, please contact Dr. Bryan Luce, Director of the PACE Initiative, at bryan.luce@unitedbiosource.com.

 
 

Dr. Luce Speaks to IOM; Recommends Focus on Clinical Trial Design Transformation

 
 

Dr. Bryan R. Luce addressed the Institute of Medicine’s Committee on Comparative Effectiveness Research Priorities on Friday, April 20, the AHRQ National Advisory Board on April 3rd, and stressing the importance of developing innovative yet pragmatic methods to pursuing real-world comparative clinical evidence.  In his statement to the IOM Committee, Dr. Luce said, “We need true transformational thinking in clinical trial design or we risk wasting vast amounts of money answering the wrong questions, or the right questions too late.”

In his written statement, Dr. Luce outlined two high priorities for comparative effectiveness, including investment in: 1) methodological innovation to improve the cost efficiency, timeliness, pragmatism, and usefulness of comparative effectiveness trials to real-world health care decision makers; and, 2) Bayesian adaptive trial methods for application to “real-world” comparative effectiveness research.  The full text of Dr. Luce's statement for the record is available here in Adobe Acrobat format (PDF).

 
 
 
 
 

© 2009 United BioSource Corporation, Inc.