Adaptive assignment versus balanced randomization in clinical trials: a decision analysis

Abstract

We compare balanced randomization with four adaptive treatment allocation procedures in a clinical trial involving two treatments. The objective is to treat as many patients in and out of the trial as effectively as possible. Randomization is a satisfactory solution to the decision problem when the disease in question is at least moderately common. Adaptive procedures are more difficult to use, but might play a role in clinical research when a substantial proportion of all patients with the disease are included in the trial.