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Adaptive Randomization to Improve Utility-Based Dose-Finding with Bivariate Ordinal Outcomes

Adaptive Randomization to Improve Utility-Based Dose-Finding with Bivariate Ordinal Outcomes

A sequentially outcome-adaptive Bayesian design is proposed for choosing the dose of an experimental therapy based on elicited utilities of a bivariate ordinal (toxicity, efficacy) outcome. Subject to posterior acceptability criteria to control the risk of severe toxicity and exclude unpromising doses, patients are randomized adaptively among the doses having …