• Anesthesiology · Aug 2022

    Understanding Research Methods: Up-and-down Designs for Dose-finding.

    • Assaf P Oron, Michael J Souter, and Nancy Flournoy.
    • Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington.
    • Anesthesiology. 2022 Aug 1; 137 (2): 137-150.

    SummaryFor the task of estimating a target benchmark dose such as the ED50 (the dose that would be effective for half the population), an adaptive dose-finding design is more effective than the standard approach of treating equal numbers of patients at a set of equally spaced doses. Up-and-down is the most popular family of dose-finding designs and is in common use in anesthesiology. Despite its widespread use, many aspects of up-and-down are not well known, implementation is often misguided, and standard, up-to-date reference material about the design is very limited. This article provides an overview of up-and-down properties, recent methodologic developments, and practical recommendations, illustrated with the help of simulated examples. Additional reference material is offered in the Supplemental Digital Content.Copyright © 2022, the American Society of Anesthesiologists. All Rights Reserved.

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