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The most common objective for response adaptive clinical trials is to seek toensure that patients within a trial have a high chance of receiving the besttreatment available by altering the chance of allocation on the basis ofaccumulating data. Approaches which yield good patient benefit propertiessuffer from low power from a frequentist perspective when testing for atreatment difference at the end of the study due to the high imbalance intreatment allocations. In this work we develop an alternative pairwise test fortreatment difference on the basis of allocation probabilities of thecovariate-adjusted response-adaptive randomization with forward looking Gittinsindex rule (CARA-FLGI). The performance of the novel test is evaluated insimulations for two-armed studies and then its applications to multi-armedstudies is illustrated. The proposed test has markedly improved power over thetraditional Fisher exact test when this class of non-myopic response adaptationis used. We also find that the test's power is close to the power of a Fisherexact test under equal randomization.

A Novel Statistical Test for Treatment Differences in Clinical Trials using a Response Adaptive Forward Looking Gittins Index Rule