ABSTRACT

In clinical trials, a typical approach for clinical evaluation of the safety and efŒcacy of a test treatment is to Œrst test for the null hypothesis of no treatment difference in efŒcacy based on clinical data collected under a valid trial design. The investigator would reject the null hypothesis of no treatment difference and then conclude the alternative hypothesis that there is a difference in favor of the test treatment under investigation. As a result, if there is a sufŒcient power for correctly detecting a clinically meaningful difference if such a difference truly exists, we claim that the test treatment is efŒcacious. The test treatment will be reviewed and approved by the regulatory agency if the recommended dose is well tolerated and there appear no safety concerns. In some cases, the regulatory agencies such as the United States FDA will issue a letter of approval pending a commitment for conducting largescale long-term safety surveillance.