Abstract
A properly designed and conducted randomized clinical trial is the most objective approach for definitive comparison of medical therapies. However, a clinical trial is a complex collaborative undertaking and requires substantial multidisciplinary planning efforts. This chapter presents the main components of a randomized trial and discusses the essential statistical concepts relevant in a trial design. The primary result and summary of statistical power, analysis, and the follow-up approach of the four recently completed pivotal clinical trials pertinent to the prevention of sudden cardiac death are summarized.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Friedman L, Furberg CD, DeMets DL. Fundamentals of clinical trials. 4th ed. New York: Springer; 2010.
Piantadosi S. Clinical trials: a methodologic perspective. 2nd ed. Hoboken: Wiley; 2005.
Chow SC, Liu JP. Design and analysis of clinical trials: concepts and methodologies. Hoboken: Wiley; 2004.
Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB. Designing clinical research. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2007.
Cook TD, DeMets DL, editors. Introduction to statistical methods for clinical trials. Boca Raton: Chapman & Hall; 2008.
Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R, Domanski M, Troutman C, Anderson J, Johnson G, McNulty SE, Clapp-Channing N, Davidson-Ray LD, Fraulo ES, Fishbein DP, Luceri RM, Ip JH, for the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med 2005; 352:225–37.
Boyle CA, Decoufle P. National sources of vital status information extent of coverage and possible selectivity in reporting. Am J Epidemiol. 1990;131:160–8.
National Research Council. The prevention and treatment of missing data in clinical trials. Panel on handling missing data in clinical trials. Committee on National Statistics. In: DoBaSSa, editor. Education. Washington, DC: The National Academies Press; 2010.
DeMets DL, Furberg CD, Friedman LM, editors. Data monitoring in clinical trials: a case studies approach. New York: Springer; 2006.
Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH, et al. Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The cardiac arrhythmia suppression trial. N Engl J Med. 1991;324:781–8.
Al-Khatib SM, Sanders GD, Mark DB, Lee KL, Bardy GH, Bigger JT, et al. Implantable cardioverter defibrillators and cardiac resynchronization therapy in patients with left ventricular dysfunction: randomized trial evidence through 2004. Am Heart J. 2005;149:1020–34.
Chow SC, Chang M. Adaptive design methods in clinical trials. 2nd ed. New York: Chapman & Hall/CRC; 2011.
Fleming TR. Standard versus adaptive monitoring procedures: a commentary. Stat Med. 2006;25:3305–12.
Proschan MA, Lan KKG, Wittes JT. Statistical monitoring of clinical trials: a unified approach. New York: Springer; 2006.
Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G. A randomized study of the prevention of sudden death in patients with coronary artery disease. N Engl J Med. 1999;341:1882–90.
Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002;346:877–83.
Kadish A, Dyer A, Daubert JP, Quigg R, Estes NA, Anderson KP, et al. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. N Engl J Med. 2004;350:2151–8.
Liu MB, Davis K. A clinical trials manual from The Duke Clinical Research Institute: lessons from a Horse Named Jim. 2nd ed. Hoboken: Wiley-Blackwell; 2010.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag London
About this chapter
Cite this chapter
Kosinski, A.S. (2013). Clinical Trials in Sudden Cardiac Death Prevention: Principles and Endpoints. In: Gussak, I., Antzelevitch, C. (eds) Electrical Diseases of the Heart. Springer, London. https://doi.org/10.1007/978-1-4471-4978-1_31
Download citation
DOI: https://doi.org/10.1007/978-1-4471-4978-1_31
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-4471-4977-4
Online ISBN: 978-1-4471-4978-1
eBook Packages: MedicineMedicine (R0)