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<span>Design elements</span> </div> </a> <button aria-controls="toc-Design_elements-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Design elements subsection</span> </button> <ul id="toc-Design_elements-sublist" class="vector-toc-list"> <li id="toc-Master_protocol" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Master_protocol"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Master protocol</span> </div> </a> <ul id="toc-Master_protocol-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Common_control_group" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Common_control_group"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Common control group</span> </div> </a> <ul id="toc-Common_control_group-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Adaptive_intervention_groups" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Adaptive_intervention_groups"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Adaptive intervention groups</span> </div> </a> <ul id="toc-Adaptive_intervention_groups-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Response-adaptive_randomization" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Response-adaptive_randomization"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.4</span> <span>Response-adaptive randomization</span> </div> </a> <ul id="toc-Response-adaptive_randomization-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Limitations" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Limitations"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Limitations</span> </div> </a> <ul id="toc-Limitations-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div 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class="mw-page-title-main">Platform trial</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="This article exist only in this language. 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data-event-name="pinnable-header.vector-appearance.unpin">hide</button> </div> </div> </div> </nav> </div> </div> <div id="bodyContent" class="vector-body" aria-labelledby="firstHeading" data-mw-ve-target-container> <div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Type of clinical trial</div> <p>A <b>platform trial</b> is a type of prospective, disease-focused,<sup id="cite_ref-Park_2020_1-0" class="reference"><a href="#cite_note-Park_2020-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Adaptive_clinical_trial" class="mw-redirect" title="Adaptive clinical trial">adaptive</a>, <a href="/wiki/Clinical_trial" title="Clinical trial">randomized clinical trial</a> (RCT) that compares multiple, simultaneous and possibly differently-timed interventions against a single, constant <a href="/wiki/Treatment_and_control_groups" title="Treatment and control groups">control group</a>.<sup id="cite_ref-Angus_2020_2-0" class="reference"><a href="#cite_note-Angus_2020-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> As a disease-focused trial design (compared to an intervention-focused), platform trials attempt to answer the question "which therapy will best treat this disease". Platform trials are unique in their utilization of both: a common <a href="/wiki/Treatment_and_control_groups" title="Treatment and control groups">control group</a> and their opportunity to alter the therapies it investigates during its active enrollment phase. Platform trials commonly take advantage of <a href="/wiki/Bayesian_inference" title="Bayesian inference">Bayesian statistics</a>, but may incorporate elements of <a href="/wiki/Frequentist_inference" title="Frequentist inference">frequentist statistics</a> and/or <a href="/wiki/Machine_learning" title="Machine learning">machine learning</a>.<sup id="cite_ref-:0_3-0" class="reference"><a href="#cite_note-:0-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Purpose">Purpose</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Platform_trial&action=edit&section=1" title="Edit section: Purpose"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Platform trials can be a particularly useful design when researchers predict that multiple therapies that would become available at different times require investigation. For example, when the <a href="/wiki/COVID-19_pandemic" title="COVID-19 pandemic">COVID-19 pandemic</a> began, researchers predicted that there would eventually be multiple different therapies that could be investigated, but that these therapies would be discovered at different times in the pandemic timeline, therefore making a platform trial a useful design.<sup id="cite_ref-Angus_2020_2-1" class="reference"><a href="#cite_note-Angus_2020-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Similar to COVID-19, platform trials have found use in oncology, alzheimer's disease and pneumonia research.<sup id="cite_ref-Park_2020_1-1" class="reference"><a href="#cite_note-Park_2020-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Platform trials can be a superior design compared to simple 2-arm clinical trials when multiple therapies need investigation, because it only requires a single control group. This means that platform trials can be conducted with fewer enrolled patients than a set of potentially redundant control groups in a series of separate 2-arm trials. This in turn allows for results to be published sooner for time-sensitive diseases, and for fewer patients to be exposed to the risks of a clinical trial.<sup id="cite_ref-Park_2022_4-0" class="reference"><a href="#cite_note-Park_2022-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Platform trials may be appropriate for phase II-IV trails.<sup id="cite_ref-:0_3-1" class="reference"><a href="#cite_note-:0-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Design_elements">Design elements</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Platform_trial&action=edit&section=2" title="Edit section: Design elements"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Master_protocol">Master protocol</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Platform_trial&action=edit&section=3" title="Edit section: Master protocol"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Platform trials, like any clinical trial, have many elements that must be established before starting enrollment. While platform trials have the ability to alter their therapies of interest there are still many elements of these trials that remain constant and regulated. Such common, stable elements of platform trials described in the master protocol include: qualified trial staff members, trial sites, recruitment criteria, enrollment procedures, pre-set criteria for adding/discontinuing new therapies, adverse event reporting, communication plans, and statistical analysis plans. The master protocol is submitted to the <a href="/wiki/Institutional_review_board" title="Institutional review board">IRB</a> and once approved, only arm-specific appendices need to be submitted for <a href="/wiki/Institutional_review_board" title="Institutional review board">Institutional Review Board</a> (IRB) approval in the event of changes to the trial arms. Establishing a stable master protocol with adaptive therapy arms allows for faster, more efficient trial execution. </p><p>Platform trials are often large, multi-site investigations and as a result, master protocols frequently try to identify common human and physical infrastructure to maximize resource availability and efficiency. Examples of this include identifying/creating a single IRB to review the trial for all sites, creating a single database for collecting data, and creating a single randomization mechanism for all enrolled patients.<sup id="cite_ref-Park_2022_4-1" class="reference"><a href="#cite_note-Park_2022-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Common_control_group">Common control group</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Platform_trial&action=edit&section=4" title="Edit section: Common control group"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>One of the defining aspects of a platform trial is the shared control group that all interventional arms are compared to. Whereas a conventional RCT would generally have half of all enrolled patients in the control group; platform trials have a higher total number of patients in various interventional groups. This allows for fewer patients to be enrolled which saves money and accelerates completion time.<sup id="cite_ref-Park_2022_4-2" class="reference"><a href="#cite_note-Park_2022-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> A common statistical tool for determining allocation ratios, <a href="/wiki/Dunnett%27s_test" title="Dunnett's test">Dunnett's test</a>,<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> suggests that n√t patients should be allocated to the control group; where "n" is the sample size for each of the arms and "√t" is the number of active arms. As the number of arms increase, the ratio of patients allocated to control also increases. This results in the control group having a higher proportion of allocated patients than any one arm<sup id="cite_ref-Park_2020_1-2" class="reference"><a href="#cite_note-Park_2020-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> though platform trials still allow for more total patients to be in intervention arms than multiple 2-arm RCTs. </p><p>While the control group is not necessarily designed to change in the way that the treatment arms are, because platform trials can run for long periods of time, control groups may have to evolve to stay current with standard of care. When this is the case, or if there is a change to patient demographics with time, later analysis of the trial must be careful to consider comparing investigational patients to only the appropriate subset of control patients. </p> <div class="mw-heading mw-heading3"><h3 id="Adaptive_intervention_groups">Adaptive intervention groups</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Platform_trial&action=edit&section=5" title="Edit section: Adaptive intervention groups"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The second defining aspect of a platform is that the therapies under investigation can change during the active enrollment phase of a trial. By comparison, conventional RCTs must specify the therapies under investigation before active enrollment and then discontinuation of a therapy results in discontinuation of the entire trial. Platform designs allow for addition and/or discontinuation of therapy arms. Importantly, the addition or discontinuation of an arm must follow pre-set protocols such as reaching a certain demonstrated efficacy or being recommended by a set panel of experts. There are frequently caps to the number of arms that can be active at once which are pre-determined by the research team. The number of possible arms is influenced by considerations of cost, time available for the trial, operational feasibility, complications with organization large quantities of patient data and the number of total patients available for enrollment.<sup id="cite_ref-Park_2020_1-3" class="reference"><a href="#cite_note-Park_2020-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> While an arm most frequently represents a single therapy, advanced designs may have multiple therapies in a single arm. When this is the case, one arm may have different therapies in different therapy classes (i.e. one <a href="/wiki/Antibiotic" title="Antibiotic">antibiotic</a> and one <a href="/wiki/Immunotherapy" title="Immunotherapy">immunomodulator</a>).<sup id="cite_ref-Angus_2020_2-2" class="reference"><a href="#cite_note-Angus_2020-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Another advanced strategy is for each arm to utilize the same treatments, but with each arm representing a different sequence of intervention administration.<sup id="cite_ref-:0_3-2" class="reference"><a href="#cite_note-:0-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Advance trials may also be designed such that some arms are only activated depending on the results of other arms. For example, a higher-dose arm may only be activated if a lower-dose arm shows few side effects but also low efficacy. </p><p>Unlike conventional RCTs, intervention arms do not necessarily need to start at the same time chronologically. This feature is particularly useful when investigating diseases that have new therapies being discovered regularly since these new therapies can be added to the trial without needing to start a new trial each time a therapy is discovered. </p> <div class="mw-heading mw-heading3"><h3 id="Response-adaptive_randomization">Response-adaptive randomization</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Platform_trial&action=edit&section=6" title="Edit section: Response-adaptive randomization"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Response-adaptive randomization is not a necessary component of platform trials but unique aspects of platforms allow for this feature to be incorporated. Response-adaptive randomization refers to the capability of redistributing the patient allocation ratio when one arm is showing superior/inferior outcomes compared to other arms after an interim analysis. Allocation ratios can therefor be adjusted to put more patients into more successful arms; however the ratio of patients randomized to the control group does not change.<sup id="cite_ref-Park_2022_4-3" class="reference"><a href="#cite_note-Park_2022-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Allocation ratios are determined through a mix of empirical interim evidence and simulation modeling. Care must be taken, especially early in the trial when limited sample sizes are available, to avoid extreme swings in allocation ratios as such swings could cause early biasing of data.<sup id="cite_ref-:0_3-3" class="reference"><a href="#cite_note-:0-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Limitations">Limitations</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Platform_trial&action=edit&section=7" title="Edit section: Limitations"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>While platform trials offer many advantages for investigating a single disease, their adaptive nature and potential for numerous and complicated arms may limit their applicability and feasibility. Platforms require a large number of experts for trial design, Data Monitoring and Safety Boards and operations leading to high cost and communication complexity. The long duration of platform trials may necessitate updates to the <a href="/wiki/Standard_of_care" title="Standard of care">standard of care</a> in the control group, complicating analysis. Further, care must be taken to ensure that the data from arms added later are compared to appropriate sub-sections of the control group, increasing statistical complexity. Publishing results of terminated arms can also be complicated if the whole trial has not yet been completed, as shared data in the trial may still need to remain blinded. Additionally, the complexity of platform designs—often involving multiple sponsors and funding sources as well as changing treatment arms—can make them difficult to register in standardized databases. Platform trials require long planning times, making them unsuitable for therapies needing immediate investigation. Funding can be complicated when different pharmaceutical companies are involved, and the ill-defined trial lengths make them less appealing to federal funding agencies.<sup id="cite_ref-:0_3-4" class="reference"><a href="#cite_note-:0-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Platform_trial&action=edit&section=8" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Clinical_trial" title="Clinical trial">Clinical Trial</a></li> <li><a href="/wiki/Adaptive_clinical_trial" class="mw-redirect" title="Adaptive clinical trial">Adaptive Clinical Trial</a></li> <li><a href="/wiki/Clinical_study_design" title="Clinical study design">Clinical Study Design</a></li> <li><a href="/wiki/Bayesian_experimental_design" title="Bayesian experimental design">Bayesian Experimental Design</a></li> <li><a href="/wiki/AGILE" title="AGILE">AGILE</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Platform_trial&action=edit&section=9" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap"><ol class="references"> <li id="cite_note-Park_2020-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-Park_2020_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Park_2020_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Park_2020_1-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Park_2020_1-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output 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href="/wiki/Template:Medical_research_studies" title="Template:Medical research studies"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Medical_research_studies" title="Template talk:Medical research studies"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Medical_research_studies" title="Special:EditPage/Template:Medical research studies"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Clinical_research_and_experimental_design" style="font-size:114%;margin:0 4em"><a href="/wiki/Clinical_research" title="Clinical research">Clinical research</a> and <a href="/wiki/Design_of_experiments" title="Design of experiments">experimental design</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Overview</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Clinical_trial" title="Clinical trial">Clinical trial</a> <ul><li><a href="/wiki/Protocol_(science)" title="Protocol (science)">Trial protocols</a></li> <li><a href="/wiki/Adaptive_clinical_trial" class="mw-redirect" title="Adaptive clinical trial">Adaptive clinical trial</a></li></ul></li> <li><a href="/wiki/Academic_clinical_trials" class="mw-redirect" title="Academic clinical trials">Academic clinical trials</a></li> <li><a href="/wiki/Clinical_study_design" title="Clinical study design">Clinical study design</a></li> <li><a href="/wiki/Evidence-based_medicine" title="Evidence-based medicine">Evidence-based medicine</a></li> <li><a href="/wiki/Real_world_evidence" title="Real world evidence">Real world evidence</a></li> <li><a href="/wiki/Patient_and_public_involvement" title="Patient and public involvement">Patient and public involvement</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Scientific_control" title="Scientific control">Controlled study</a><br />(<a href="/wiki/Hierarchy_of_evidence#USA" title="Hierarchy of evidence">EBM I to II-1</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Randomized_controlled_trial" title="Randomized controlled trial">Randomized controlled trial</a> <ul><li><a href="/wiki/Experiment" title="Experiment">Scientific experiment</a></li> <li><a href="/wiki/Blind_experiment" class="mw-redirect" title="Blind experiment">Blind experiment</a></li> <li><a href="/wiki/Open-label_trial" title="Open-label trial">Open-label trial</a></li></ul></li> <li><a href="/wiki/Adaptive_clinical_trial" class="mw-redirect" title="Adaptive clinical trial">Adaptive clinical trial</a> <ul><li><a class="mw-selflink selflink">Platform trial</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Observational_study" title="Observational study">Observational study</a><br />(<a href="/wiki/Hierarchy_of_evidence#USA" title="Hierarchy of evidence">EBM II-2 to II-3</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cross-sectional_study" title="Cross-sectional study">Cross-sectional study</a> vs. <a href="/wiki/Longitudinal_study" title="Longitudinal study">Longitudinal study</a>, <a href="/wiki/Ecological_study" title="Ecological study">Ecological study</a></li> <li><a href="/wiki/Cohort_study" title="Cohort study">Cohort study</a> <ul><li><a href="/wiki/Retrospective_cohort_study" title="Retrospective cohort study">Retrospective</a></li> <li><a href="/wiki/Prospective_cohort_study" title="Prospective cohort study">Prospective</a></li></ul></li> <li><a href="/wiki/Case%E2%80%93control_study" title="Case–control study">Case–control study</a> (<a href="/wiki/Nested_case%E2%80%93control_study" title="Nested case–control study">Nested case–control study</a>)</li> <li><a href="/wiki/Case_series" title="Case series">Case series</a></li> <li><a href="/wiki/Case_study" title="Case study">Case study</a></li> <li><a href="/wiki/Case_report" title="Case report">Case report</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Outcome_measure" title="Outcome measure">Measures</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Epidemiological_methods#Measures_of_occurrence" class="mw-redirect" title="Epidemiological methods">Occurrence</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><a href="/wiki/Incidence_(epidemiology)" title="Incidence (epidemiology)">Incidence</a>, <a href="/wiki/Cumulative_incidence" class="mw-redirect" title="Cumulative incidence">Cumulative incidence</a>, <a href="/wiki/Prevalence" title="Prevalence">Prevalence</a>, <a href="/wiki/Point_prevalence" class="mw-redirect" title="Point prevalence">Point prevalence</a>, <a href="/wiki/Period_prevalence" class="mw-redirect" title="Period prevalence">Period prevalence</a></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Epidemiological_methods#Measures_of_association" class="mw-redirect" title="Epidemiological methods">Association</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><a href="/wiki/Risk_difference" title="Risk difference">Risk difference</a>, <a href="/wiki/Number_needed_to_treat" title="Number needed to treat">Number needed to treat</a>, <a href="/wiki/Number_needed_to_harm" title="Number needed to harm">Number needed to harm</a>, <a href="/wiki/Risk_ratio" class="mw-redirect" title="Risk ratio">Risk ratio</a>, <a href="/wiki/Relative_risk_reduction" title="Relative risk reduction">Relative risk reduction</a>, <a href="/wiki/Odds_ratio" title="Odds ratio">Odds ratio</a>, <a href="/wiki/Hazard_ratio" title="Hazard ratio">Hazard ratio</a></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Population_impact_measure" title="Population impact measure">Population impact</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><a href="/wiki/Attributable_fraction_among_the_exposed" title="Attributable fraction among the exposed">Attributable fraction among the exposed</a>, <a href="/wiki/Attributable_fraction_for_the_population" title="Attributable fraction for the population">Attributable fraction for the population</a>, <a href="/wiki/Preventable_fraction_among_the_unexposed" title="Preventable fraction among the unexposed">Preventable fraction among the unexposed</a>, <a href="/wiki/Preventable_fraction_for_the_population" title="Preventable fraction for the population">Preventable fraction for the population</a></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Epidemiological_methods#Other_measures" class="mw-redirect" title="Epidemiological methods">Other</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><a href="/wiki/Clinical_endpoint" title="Clinical endpoint">Clinical endpoint</a>, <a href="/wiki/Virulence" title="Virulence">Virulence</a>, <a href="/wiki/Infectivity" title="Infectivity">Infectivity</a>, <a href="/wiki/Mortality_rate" title="Mortality rate">Mortality rate</a>, <a href="/wiki/Morbidity" class="mw-redirect" title="Morbidity">Morbidity</a>, <a href="/wiki/Case_fatality_rate" title="Case fatality rate">Case fatality rate</a>, <a href="/wiki/Specificity_and_sensitivity" class="mw-redirect" title="Specificity and sensitivity">Specificity and sensitivity</a>, <a href="/wiki/Likelihood_ratios_in_diagnostic_testing" title="Likelihood ratios in diagnostic testing">Likelihood-ratios</a>, <a href="/wiki/Pre-_and_post-test_probability" title="Pre- and post-test probability">Pre- and post-test probability</a></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Trial/test types</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/In_vitro" title="In vitro">In vitro</a></li> <li><a href="/wiki/In_vivo" title="In vivo">In vivo</a></li> <li><a href="/wiki/Animal_testing" title="Animal testing">Animal testing</a></li> <li><a href="/wiki/Animal_testing_on_non-human_primates" title="Animal testing on non-human primates">Animal testing on non-human primates</a></li> <li><a href="/wiki/First-in-man_study" class="mw-redirect" title="First-in-man study">First-in-man study</a></li> <li><a href="/wiki/Multicenter_trial" title="Multicenter trial">Multicenter trial</a></li> <li><a href="/wiki/Seeding_trial" title="Seeding trial">Seeding trial</a></li> <li><a href="/wiki/Vaccine_trial" title="Vaccine trial">Vaccine trial</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Analysis_of_clinical_trials" title="Analysis of clinical trials">Analysis of clinical trials</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Risk%E2%80%93benefit_ratio" title="Risk–benefit ratio">Risk–benefit ratio</a></li> <li><a href="/wiki/Systematic_review" title="Systematic review">Systematic review</a></li> <li><a href="/wiki/Reproducibility" title="Reproducibility">Replication</a></li> <li><a href="/wiki/Meta-analysis" title="Meta-analysis">Meta-analysis</a></li> <li><a href="/wiki/Intention-to-treat_analysis" title="Intention-to-treat analysis">Intention-to-treat analysis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Interpretation of results</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Selection_bias" title="Selection bias">Selection bias</a></li> <li><a href="/wiki/Survivorship_bias" title="Survivorship bias">Survivorship bias</a></li> <li><a href="/wiki/Correlation_does_not_imply_causation" title="Correlation does not imply causation">Correlation does not imply causation</a></li> <li><a href="/wiki/Null_result" title="Null result">Null result</a></li> <li><a href="/wiki/Sex_as_a_biological_variable" title="Sex as a biological variable">Sex as a biological variable</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div> 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