Applied Adaptive Optimal Design and Novel Optimization Algorithms for Practical Use

Abstract: The costs of developing new pharmaceuticals have increased dramatically during the past decades. Contributing to these increased expenses are the increasingly extensive and more complex clinical trials required to generate sufficient evidence regarding the safety and efficacy of the drugs.  It is therefore of great importance to improve the effectiveness of the clinical phases by increasing the information gained throughout the process so the correct decision may be made as early as possible.   Optimal Design (OD) methodology using the Fisher Information Matrix (FIM) based on Nonlinear Mixed Effect Models (NLMEM) has been proven to serve as a useful tool for making more informed decisions throughout the clinical investigation. The calculation of the FIM for NLMEM does however lack an analytic solution and is commonly approximated by linearization of the NLMEM. Furthermore, two structural assumptions of the FIM is available; a full FIM and a block-diagonal FIM which assumes that the fixed effects are independent of the random effects in the NLMEM. Once the FIM has been derived, it can be transformed into a scalar optimality criterion for comparing designs. The optimality criterion may be considered local, if the criterion is based on singe point values of the parameters or global (robust), where the criterion is formed for a prior distribution of the parameters.  Regardless of design criterion, FIM approximation or structural assumption, the design will be based on the prior information regarding the model and parameters, and is thus sensitive to misspecification in the design stage.  Model based adaptive optimal design (MBAOD) has however been shown to be less sensitive to misspecification in the design stage.   The aim of this thesis is to further the understanding and practicality when performing standard and MBAOD. This is to be achieved by: (i) investigating how two common FIM approximations and the structural assumptions may affect the optimized design, (ii) reducing runtimes complex design optimization by implementing a low level parallelization of the FIM calculation, (iii) further develop and demonstrate a framework for performing MBAOD, (vi) and investigate the potential advantages of using a global optimality criterion in the already robust MBAOD.