Platform Trials: the Impact of common Controls on Type One Error and Power
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Platform trials offer a framework to study multiple interventions in a single trial with the opportunity of opening and closing arms. The use of a common control in platform trials can increase efficiency as compared to individual control arms or separate trials per treatment. However, the need for multiplicity adjustment as a consequence of common controls is currently a controversial debate among researchers, pharmaceutical companies, as well as regulators. We investigate the impact of a common control arm in platform trials on the type one error and power in comparison to what would have been obtained with a platform trial with individual control arms in a simulation study. Furthermore, we evaluate the impact on power in case multiplicity adjustment is required in a platform trial. In both study designs, the family-wise error rate (FWER) is inflated compared to a standard, two-armed randomized controlled trial when no multiplicity adjustment is applied. In case of a common control, the FWER inflation is smaller. In most circumstances, a platform trial with a common control is still beneficial in terms of sample size and power after multiplicity adjustment, whereas in some cases, the platform trial with a common control loses the efficiency gain. Therefore, we further discuss the need for adjustment in terms of a family definition or hypotheses dependencies.
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