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American Journal of Epidemiology 2005 161(6):595-603; doi:10.1093/aje/kwi065
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved

SPECIAL 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 Kpozèhouen1, Ahmadou Alioum2, Xavier Anglaret1, Philippe Van de Perre3, Geneviève Chêne1 and Roger Salamon1

1 INSERM U 593, Université Victor Segalen Bordeaux 2, France
2 INSERM E 0338, Université Victor Segalen Bordeaux 2, France
3 Regional Hospital Center, Laboratory of Bacteriology-Virology, Montpellier, France

Correspondence to Dr. Alphonse Kpozèhouen, INSERM U 593, Université Victor Segalen Bordeaux 2, 146, rue Léo-Saignat, 33076 Bordeaux Cedex, France (e-mail: Alphonse.Kpozehouen{at}isped.u-bordeaux2.fr).

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.

Bayesian approach; cotrimoxazole; counting process; Cox model; directed acyclic graph; Gibbs sampling

Abbreviations: ANRS   Agence Nationale de Recherche sur le Sida; CI   Côte d'Ivoire; HIV   human immunodeficiency virus


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P. A. H. van Noord and I. van der Tweel
RE: "USE OF A BAYESIAN APPROACH TO DECIDE WHEN TO STOP A THERAPEUTIC TRIAL: THE CASE OF A CHEMOPROPHYLAXIS TRIAL IN HUMAN IMMUNODEFICIENCY VIRUS INFECTION"
Am. J. Epidemiol., November 15, 2005; 162(10): 1033 - 1035.
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