Two Stage Sampling for Simultaneously Testing Main and Side Effects in Clinical Trials

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Abstract
In clinical trials for the comparison of two treatments it seems reasonable to stop the study if either one treatment has worked out to be markedly superior in the main effect, or one to be severely inferior with respect to an adverse side effect. Two stage sampling plans are considered for simultaneously testing a main and side effect, assumed to follow a bivariate normal distribution with known variances, but unknown correlation. The test procedure keeps the global significance level under the null hypothesis of no differences in main and side effects. The critical values are chosen under the side condition, that the probability for ending at the first or second stage with a rejection of the elementary null hypothesis for the main effect is controlled, when a particular constellation of differences in mean holds; analogously the probability of ending with a rejection of the null hypotheses for the side effect, given certain treatment differences, is controlled too. Plans “optimal” with respect to sample size are given.

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