The Innovative Medicines Initiative funded a proposal (INNODIA) with many European partners. At the heart of this project is an observational cohort of newly diagnosed type I diabetics. The platform trial is well suited to the design of multiple sub-trials to increase efficiency in protocol development, recruitment and laboratory measurements. Currently there are four different trials being planned within this platform. The plans are this platform will continue for as long as possible so we keep accruing information from the numerous trials and the observational cohort. One of the challenges in type I diabetes is the current “best” measure of disease is the stimulated C-peptide response and this is often summarised over 2 or 4 hours. The test requires a clinical visit and places a burden on the participants, and leads to higher drop out rates during a trial/follow-up. Additionally, there are many other outcomes that are being measured more frequently at home such as dried blood spot C-peptide and continuous glucose monitors. From the clinical visits, blood samples are used to measure many immune markers and other biomarkers that could be used as outcomes or predictors of treatment response. This project will use these data to investigate the quality of endpoints, and how to use all this information to improve the design and analysis of future sub-trials.
Often when trialists are faced with multiple outcomes create a combined composite score and simplify analysis by using a single outcome. Combination of outcomes could use equal weights or other weighting schemes to improve the power of a trial/analysis. This approach may lead to inefficient trials, diluting treatment effects and with results that are hard to interpret. This project will investigate methods that can handle multiple outcomes with the appropriate multiplicity correction whilst still retaining efficiency, such as closed testing procedures or methods of k-Family-wise error rate. As the data are measured over time there are issues of missing data, either sporadic missingness or loss to follow-up. Currently, we design trials assuming a certain amount of dropout and thereby increasing the sample size to compensate. However, this project will investigate different modelling strategies and try to use historical missingness patterns to determine better sample size calculations
Work will include obtaining data from the INNODIA observational cohort and model the outcome data using longitudinal data techniques. This will give an idea of how the data are distributed and an idea of the estimated correlations, variances and potential effect sizes. The analysis will then lead on to how the trials are currently designed but how to design a new study incorporating multiple outcomes. This will include the use of the k-familywise error rate, composite endpoints, various multiplicity corrections such as sequential closed testing procedures.
The main methodological focus should be on the joint modelling MMTT and DBS C-peptide values and how to design a trial that encorporates longitudinal outcome data. In particular given historical missing data mechanisms how to calculate sample sizes that are more realistic. Then the project will investigate how to do interim analyses in a two-arm parallel groups trial to either stop the trial or continue. This will require the adaptation of methods in Jennison and Turnbull’s book on group sequential trials and also the development of methodology to work out the full distribution of the test statistics and how to calculate the most efficient boundary conditions to either minimise expected sample sizes or a loss function that encorporates expected sample sizes under the null, alternative and the maximum sample size. This work will either be extended by including more outcome variables and or treatment arms.
This is a competitive process, with four projects advertised and only one studentship will be funded. The studentship is generously funded by the School of Medicine as part of the MRC NIHR Trials Methodology Research Partnership (TMRP).
Open to all UK/EU students without further restrictions
Full UK/EU tuition fees
Doctoral stipend matching UK Research Council National Minimum.
Additional funding is available over the course of the programme and will cover costs such as research consumables and training.
Applications from International candidates are welcomed if they can cover the difference in home/Eu fees (£4,407) and Overseas fees (£21,950).
The TMRP brings together a number of national and international networks, institutions and partners undertaking clinical trials and trials methodology research. Our overall aim being to improve patient care by improving the way in which the healthcare evidence base is developed.
Our PhD programme presents a unique opportunity to undertake training and research in major areas where clinical trials need to be improved to help increase the health of society. Projects are available at locations across the UK for candidates with qualifications in a variety of subject areas including statistics, mathematics, health economics, epidemiology, psychology, social science, computer science, informatics and health services research.
What is included?
• Funding is available to support PhD study, tuition fees and student stipend.
• A broad range of trials methodology research training and internship opportunities across the Partnership, overseen by a Student Training Group chaired by Professor Catrin Tudur Smith (University of Liverpool)
• Membership of a student cohort, embedded within an international network of health researchers and clinical trialists
• Opportunity to join one or more of the TMRP Working Groups
• Exposure to a wide range of relevant research initiatives
Applicants should possess a minimum of an upper second class Honours degree or master's degree, or equivalent in Statistics or with a substantial statistical component.
Applicants whose first language is not English are normally expected to meet the minimum University requirements (e.g. 6.5 IELTS)
HOW TO APPLY
This studentship has a start date of October 2020. In order to be considered you must submit a formal application via Cardiff University’s online application service. (To access the system click 'Apply Online' at the bottom of this advert)
There is a box at the top right of the page labelled ‘Apply’, please ensure you select the correct ‘Qualification’ (Doctor of Philosophy), the correct ‘Mode of Study’ (Full Time) and the correct ‘Start Date’ (October 2020). This will take you to the application portal.
In order to be considered candidates must submit the following information:
• Supporting statement • CV • Qualification certificates • References x 2 • Proof of English language (if applicable)
In the 'Research proposal and Funding' section of your application, please specify the project titles and supervisors of the project/s.
Please Note* the supervisor reserves the right to close the advert early if sufficient applications are received.