Strategies for Dealing with Multiple Treatment Comparisons in Confirmatory Clinical Trials

In many clinical trials there are multiple treatments under consideration which require multiple comparisons. Investigators are faced with the problems of Type I error control (experimentwise, familywise, or comparisonwise), maintenance of reasonable power for the study, and the selection of appropriate multiple comparison techniques to achieve these. This paper reviews briefly the various multiple comparison techniques available and discusses strategies for aiding investigators in applying these in settings typical in clinical trials (eg, confirmatory studies with placebo or positive controls or both). In a confirmatory setting, the treatment comparisons can often be divided into sets or families. Appropriate multiple comparison techniques, possibly differing across families, can then be applied within and across these. Study objectives can be better achieved by employing the strategies suggested.

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