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Jan 7

Stabilizing Policy Gradients for Sample-Efficient Reinforcement Learning in LLM Reasoning

Reinforcement Learning, particularly through policy gradient methods, has played a central role in enabling reasoning capabilities of Large Language Models. However, the optimization stability of policy gradients in this setting remains understudied. As a result, existing implementations often resort to conservative hyperparameter choices to ensure stability, which requires more training samples and increases computational costs. Hence, developing models for reliably tracking the underlying optimization dynamics and leveraging them into training enables more sample-efficient regimes and further unleashes scalable post-training. We address this gap by formalizing the stochastic optimization problem of policy gradients with explicit consideration of second-order geometry. We propose a tractable computational framework that tracks and leverages curvature information during policy updates. We further employ this framework to design interventions in the optimization process through data selection. The resultant algorithm, Curvature-Aware Policy Optimization (CAPO), identifies samples that contribute to unstable updates and masks them out. Theoretically, we establish monotonic improvement guarantees under realistic assumptions. On standard math reasoning benchmarks, we empirically show that CAPO ensures stable updates under aggressive learning regimes where baselines catastrophically fail. With minimal intervention (rejecting fewer than 8% of tokens), CAPO achieves up to 30x improvement in sample efficiency over standard GRPO for LLM reasoning.

  • 3 authors
·
Oct 1, 2025

Rethinking Entropy Interventions in RLVR: An Entropy Change Perspective

While Reinforcement Learning with Verifiable Rewards (RLVR) can enhance LLM reasoning, its training process poses a critical risk: entropy collapse. This phenomenon is a rapid loss of policy diversity, stemming from the exploration-exploitation imbalance and leading to a lack of generalization. Recent entropy-intervention methods aim to prevent entropy collapse, yet their underlying mechanisms remain unclear. In this paper, we conduct a quantitative analysis to reveal token-level entropy changes and how existing entropy intervention methods help avoid entropy collapse. Our findings point out a fundamental limitation of existing methods: they attempt to control entropy dynamics indirectly. By only affecting related factors, such as the advantage signal and generation probability, their effectiveness is inherently limited and could potentially fail. To address this limitation, we introduce an entropy-change-aware reweighting scheme, namely Stabilizing Token-level Entropy-changE via Reweighting (STEER), that adaptively stabilizes entropy dynamics through fine-grained token-level adjustments. Our approach mitigates over-exploitation while fostering robust exploration. Extensive experiments demonstrate that STEER significantly mitigates entropy collapse, stabilizes entropy dynamics, and achieves stronger downstream performance across various mathematical reasoning benchmarks \footnote{Our code is available at https://github.com/zz-haooo/STEER.

  • 9 authors
·
Oct 11, 2025

A Different Approach to AI Safety: Proceedings from the Columbia Convening on Openness in Artificial Intelligence and AI Safety

The rapid rise of open-weight and open-source foundation models is intensifying the obligation and reshaping the opportunity to make AI systems safe. This paper reports outcomes from the Columbia Convening on AI Openness and Safety (San Francisco, 19 Nov 2024) and its six-week preparatory programme involving more than forty-five researchers, engineers, and policy leaders from academia, industry, civil society, and government. Using a participatory, solutions-oriented process, the working groups produced (i) a research agenda at the intersection of safety and open source AI; (ii) a mapping of existing and needed technical interventions and open source tools to safely and responsibly deploy open foundation models across the AI development workflow; and (iii) a mapping of the content safety filter ecosystem with a proposed roadmap for future research and development. We find that openness -- understood as transparent weights, interoperable tooling, and public governance -- can enhance safety by enabling independent scrutiny, decentralized mitigation, and culturally plural oversight. However, significant gaps persist: scarce multimodal and multilingual benchmarks, limited defenses against prompt-injection and compositional attacks in agentic systems, and insufficient participatory mechanisms for communities most affected by AI harms. The paper concludes with a roadmap of five priority research directions, emphasizing participatory inputs, future-proof content filters, ecosystem-wide safety infrastructure, rigorous agentic safeguards, and expanded harm taxonomies. These recommendations informed the February 2025 French AI Action Summit and lay groundwork for an open, plural, and accountable AI safety discipline.

  • 20 authors
·
Jun 27, 2025

Drift No More? Context Equilibria in Multi-Turn LLM Interactions

Large Language Models (LLMs) excel at single-turn tasks such as instruction following and summarization, yet real-world deployments require sustained multi-turn interactions where user goals and conversational context persist and evolve. A recurring challenge in this setting is context drift: the gradual divergence of a model's outputs from goal-consistent behavior across turns. Unlike single-turn errors, drift unfolds temporally and is poorly captured by static evaluation metrics. In this work, we present a study of context drift in multi-turn interactions and propose a simple dynamical framework to interpret its behavior. We formalize drift as the turn-wise KL divergence between the token-level predictive distributions of the test model and a goal-consistent reference model, and propose a recurrence model that interprets its evolution as a bounded stochastic process with restoring forces and controllable interventions. We instantiate this framework in both synthetic long-horizon rewriting tasks and realistic user-agent simulations such as in tau-Bench, measuring drift for several open-weight LLMs that are used as user simulators. Our experiments consistently reveal stable, noise-limited equilibria rather than runaway degradation, and demonstrate that simple reminder interventions reliably reduce divergence in line with theoretical predictions. Together, these results suggest that multi-turn drift can be understood as a controllable equilibrium phenomenon rather than as inevitable decay, providing a foundation for studying and mitigating context drift in extended interactions.

  • 6 authors
·
Oct 9, 2025

TV2TV: A Unified Framework for Interleaved Language and Video Generation

Video generation models are rapidly advancing, but can still struggle with complex video outputs that require significant semantic branching or repeated high-level reasoning about what should happen next. In this paper, we introduce a new class of omni video-text models that integrate ideas from recent LM reasoning advances to address this challenge. More specifically, we present TV2TV, a unified generative modeling framework which decomposes video generation into an interleaved text and video generation process. TV2TV jointly learns language modeling (next-token prediction) and video flow matching (next-frame prediction) using a Mixture-of-Transformers (MoT) architecture. At inference time, TV2TV decides when to alternate between generating text and video frames, allowing the model to "think in words" about subsequent content before ``acting in pixels'' to produce frames. This design offloads much of the responsibility for deciding what should happen next to the language modeling tower, enabling improved visual quality and prompt alignment of generated videos. It also enables fine-grained controllability, allowing users to modify the video generation trajectory through text interventions at any point in the process. In controlled experiments on video game data, TV2TV demonstrates substantial improvements in both visual quality and controllability. TV2TV also scales to natural videos, as we show by augmenting sports videos with interleaved natural language action descriptions using vision-language models (VLMs). Training TV2TV on this corpus yields strong visual quality and prompt alignment, showcasing the model's ability to reason about and generate complex real-world action sequences. Together, these results highlight TV2TV as a promising step toward video generation with open-ended textual reasoning and control.

facebook AI at Meta
·
Dec 4, 2025 2

Avoiding tipping points in fisheries management through Gaussian Process Dynamic Programming

Model uncertainty and limited data are fundamental challenges to robust management of human intervention in a natural system. These challenges are acutely highlighted by concerns that many ecological systems may contain tipping points, such as Allee population sizes. Before a collapse, we do not know where the tipping points lie, if they exist at all. Hence, we know neither a complete model of the system dynamics nor do we have access to data in some large region of state-space where such a tipping point might exist. We illustrate how a Bayesian Non-Parametric (BNP) approach using a Gaussian Process (GP) prior provides a flexible representation of this inherent uncertainty. We embed GPs in a Stochastic Dynamic Programming (SDP) framework in order to make robust management predictions with both model uncertainty and limited data. We use simulations to evaluate this approach as compared with the standard approach of using model selection to choose from a set of candidate models. We find that model selection erroneously favors models without tipping points -- leading to harvest policies that guarantee extinction. The GPDP performs nearly as well as the true model and significantly outperforms standard approaches. We illustrate this using examples of simulated single-species dynamics, where the standard model selection approach should be most effective, and find that it still fails to account for uncertainty appropriately and leads to population crashes, while management based on the GPDP does not, since it does not underestimate the uncertainty outside of the observed data.

  • 3 authors
·
Dec 27, 2014

Improve Mathematical Reasoning in Language Models by Automated Process Supervision

Complex multi-step reasoning tasks, such as solving mathematical problems or generating code, remain a significant hurdle for even the most advanced large language models (LLMs). Verifying LLM outputs with an Outcome Reward Model (ORM) is a standard inference-time technique aimed at enhancing the reasoning performance of LLMs. However, this still proves insufficient for reasoning tasks with a lengthy or multi-hop reasoning chain, where the intermediate outcomes are neither properly rewarded nor penalized. Process supervision addresses this limitation by assigning intermediate rewards during the reasoning process. To date, the methods used to collect process supervision data have relied on either human annotation or per-step Monte Carlo estimation, both prohibitively expensive to scale, thus hindering the broad application of this technique. In response to this challenge, we propose a novel divide-and-conquer style Monte Carlo Tree Search (MCTS) algorithm named OmegaPRM for the efficient collection of high-quality process supervision data. This algorithm swiftly identifies the first error in the Chain of Thought (CoT) with binary search and balances the positive and negative examples, thereby ensuring both efficiency and quality. As a result, we are able to collect over 1.5 million process supervision annotations to train a Process Reward Model (PRM). Utilizing this fully automated process supervision alongside the weighted self-consistency algorithm, we have enhanced the instruction tuned Gemini Pro model's math reasoning performance, achieving a 69.4\% success rate on the MATH benchmark, a 36\% relative improvement from the 51\% base model performance. Additionally, the entire process operates without any human intervention, making our method both financially and computationally cost-effective compared to existing methods.

  • 11 authors
·
Jun 5, 2024

Towards Safe Reasoning in Large Reasoning Models via Corrective Intervention

Although Large Reasoning Models (LRMs) have progressed in solving complex problems, their chain-of-thought (CoT) reasoning often contains harmful content that can persist even when the final responses appear safe. We show that this issue still remains in existing methods which overlook the unique significance of safe reasoning, undermining their trustworthiness and posing potential risks in applications if unsafe reasoning is accessible for and exploited by malicious users. We therefore shift our focus to aligning the safety of reasoning itself in this paper and explore process supervision as the solution. However, simply rewarding safe reasoning proves inadequate due to low rollout diversity and limited training signals. To tackle this challenge, we first delve into the characteristics of safe reasoning and uncover several critical insights that 1) safe reasoning is often consolidated by a few critical steps of safety triggers; 2) compliance cues strongly correlate with unsafe continuations; and 3) corrective interventions reliably steer unsafe trajectories towards safer traces. Motivated by these, we propose Intervened Preference Optimization (IPO), an alignment method that enforces safe reasoning by substituting compliance steps with safety triggers and constructing pairs for preference learning with strong signals. Experiments on jailbreak and adversarial safety benchmarks demonstrate that IPO remarkably improves overall safety regarding both reasoning and responses, outperforming SFT-based and RL-based baselines with a relative reduction of over 30% in harmfulness, while preserving excellent performance across diverse reasoning tasks. The results highlight the importance of explicit alignment for reasoning and provide a practical path to safer LRMs.

  • 10 authors
·
Sep 29, 2025

SmartFlow: Robotic Process Automation using LLMs

Robotic Process Automation (RPA) systems face challenges in handling complex processes and diverse screen layouts that require advanced human-like decision-making capabilities. These systems typically rely on pixel-level encoding through drag-and-drop or automation frameworks such as Selenium to create navigation workflows, rather than visual understanding of screen elements. In this context, we present SmartFlow, an AI-based RPA system that uses pre-trained large language models (LLMs) coupled with deep-learning based image understanding. Our system can adapt to new scenarios, including changes in the user interface and variations in input data, without the need for human intervention. SmartFlow uses computer vision and natural language processing to perceive visible elements on the graphical user interface (GUI) and convert them into a textual representation. This information is then utilized by LLMs to generate a sequence of actions that are executed by a scripting engine to complete an assigned task. To assess the effectiveness of SmartFlow, we have developed a dataset that includes a set of generic enterprise applications with diverse layouts, which we are releasing for research use. Our evaluations on this dataset demonstrate that SmartFlow exhibits robustness across different layouts and applications. SmartFlow can automate a wide range of business processes such as form filling, customer service, invoice processing, and back-office operations. SmartFlow can thus assist organizations in enhancing productivity by automating an even larger fraction of screen-based workflows. The demo-video and dataset are available at https://smartflow-4c5a0a.webflow.io/.

  • 5 authors
·
May 21, 2024

Making Small Language Models Efficient Reasoners: Intervention, Supervision, Reinforcement

Recent research enhances language model reasoning by scaling test-time compute via longer chain-of-thought traces. This often improves accuracy but also introduces redundancy and high computational cost, especially for small language models distilled with supervised fine-tuning (SFT). In this work, we propose new algorithms to improve token-efficient reasoning with small-scale models by effectively trading off accuracy and computation. We first show that the post-SFT model fails to determine the optimal stopping point of the reasoning process, resulting in verbose and repetitive outputs. Verbosity also significantly varies across wrong vs correct responses. To address these issues, we propose two solutions: (1) Temperature scaling (TS) to control the stopping point for the thinking phase and thereby trace length, and (2) TLDR: a length-regularized reinforcement learning method based on GRPO that facilitates multi-level trace length control (e.g. short, medium, long reasoning). Experiments on four reasoning benchmarks, MATH500, AMC, AIME24 and OlympiadBench, demonstrate that TS is highly effective compared to s1's budget forcing approach and TLDR significantly improves token efficiency by about 50% with minimal to no accuracy loss over the SFT baseline. Moreover, TLDR also facilitates flexible control over the response length, offering a practical and effective solution for token-efficient reasoning in small models. Ultimately, our work reveals the importance of stopping time control, highlights shortcomings of pure SFT, and provides effective algorithmic recipes.

  • 6 authors
·
May 12, 2025

Abduct, Act, Predict: Scaffolding Causal Inference for Automated Failure Attribution in Multi-Agent Systems

Failure attribution in multi-agent systems -- pinpointing the exact step where a decisive error occurs -- is a critical yet unsolved challenge. Current methods treat this as a pattern recognition task over long conversation logs, leading to critically low step-level accuracy (below 17\%), which renders them impractical for debugging complex systems. Their core weakness is a fundamental inability to perform robust counterfactual reasoning: to determine if correcting a single action would have actually averted the task failure. To bridge this counterfactual inference gap, we introduce Abduct-Act-Predict (A2P) Scaffolding, a novel agent framework that transforms failure attribution from pattern recognition into a structured causal inference task. A2P explicitly guides a large language model through a formal three-step reasoning process within a single inference pass: (1) Abduction, to infer the hidden root causes behind an agent's actions; (2) Action, to define a minimal corrective intervention; and (3) Prediction, to simulate the subsequent trajectory and verify if the intervention resolves the failure. This structured approach leverages the holistic context of the entire conversation while imposing a rigorous causal logic on the model's analysis. Our extensive experiments on the Who\&When benchmark demonstrate its efficacy. On the Algorithm-Generated dataset, A2P achieves 47.46\% step-level accuracy, a 2.85times improvement over the 16.67\% of the baseline. On the more complex Hand-Crafted dataset, it achieves 29.31\% step accuracy, a 2.43times improvement over the baseline's 12.07\%. By reframing the problem through a causal lens, A2P Scaffolding provides a robust, verifiable, and significantly more accurate solution for automated failure attribution. Ours code are released at https://github.com/ResearAI/A2P.

  • 6 authors
·
Sep 12, 2025

Med-PerSAM: One-Shot Visual Prompt Tuning for Personalized Segment Anything Model in Medical Domain

Leveraging pre-trained models with tailored prompts for in-context learning has proven highly effective in NLP tasks. Building on this success, recent studies have applied a similar approach to the Segment Anything Model (SAM) within a ``one-shot" framework, where only a single reference image and its label are employed. However, these methods face limitations in the medical domain, primarily due to SAM's essential requirement for visual prompts and the over-reliance on pixel similarity for generating them. This dependency may lead to (1) inaccurate prompt generation and (2) clustering of point prompts, resulting in suboptimal outcomes. To address these challenges, we introduce Med-PerSAM, a novel and straightforward one-shot framework designed for the medical domain. Med-PerSAM uses only visual prompt engineering and eliminates the need for additional training of the pretrained SAM or human intervention, owing to our novel automated prompt generation process. By integrating our lightweight warping-based prompt tuning model with SAM, we enable the extraction and iterative refinement of visual prompts, enhancing the performance of the pre-trained SAM. This advancement is particularly meaningful in the medical domain, where creating visual prompts poses notable challenges for individuals lacking medical expertise. Our model outperforms various foundational models and previous SAM-based approaches across diverse 2D medical imaging datasets.

  • 4 authors
·
Nov 25, 2024

IMBUE: Improving Interpersonal Effectiveness through Simulation and Just-in-time Feedback with Human-Language Model Interaction

Navigating certain communication situations can be challenging due to individuals' lack of skills and the interference of strong emotions. However, effective learning opportunities are rarely accessible. In this work, we conduct a human-centered study that uses language models to simulate bespoke communication training and provide just-in-time feedback to support the practice and learning of interpersonal effectiveness skills. We apply the interpersonal effectiveness framework from Dialectical Behavioral Therapy (DBT), DEAR MAN, which focuses on both conversational and emotional skills. We present IMBUE, an interactive training system that provides feedback 25% more similar to experts' feedback, compared to that generated by GPT-4. IMBUE is the first to focus on communication skills and emotion management simultaneously, incorporate experts' domain knowledge in providing feedback, and be grounded in psychology theory. Through a randomized trial of 86 participants, we find that IMBUE's simulation-only variant significantly improves participants' self-efficacy (up to 17%) and reduces negative emotions (up to 25%). With IMBUE's additional just-in-time feedback, participants demonstrate 17% improvement in skill mastery, along with greater enhancements in self-efficacy (27% more) and reduction of negative emotions (16% more) compared to simulation-only. The improvement in skill mastery is the only measure that is transferred to new and more difficult situations; situation specific training is necessary for improving self-efficacy and emotion reduction.

  • 6 authors
·
Feb 19, 2024

An Analysis of Causal Effect Estimation using Outcome Invariant Data Augmentation

The technique of data augmentation (DA) is often used in machine learning for regularization purposes to better generalize under i.i.d. settings. In this work, we present a unifying framework with topics in causal inference to make a case for the use of DA beyond just the i.i.d. setting, but for generalization across interventions as well. Specifically, we argue that when the outcome generating mechanism is invariant to our choice of DA, then such augmentations can effectively be thought of as interventions on the treatment generating mechanism itself. This can potentially help to reduce bias in causal effect estimation arising from hidden confounders. In the presence of such unobserved confounding we typically make use of instrumental variables (IVs) -- sources of treatment randomization that are conditionally independent of the outcome. However, IVs may not be as readily available as DA for many applications, which is the main motivation behind this work. By appropriately regularizing IV based estimators, we introduce the concept of IV-like (IVL) regression for mitigating confounding bias and improving predictive performance across interventions even when certain IV properties are relaxed. Finally, we cast parameterized DA as an IVL regression problem and show that when used in composition can simulate a worst-case application of such DA, further improving performance on causal estimation and generalization tasks beyond what simple DA may offer. This is shown both theoretically for the population case and via simulation experiments for the finite sample case using a simple linear example. We also present real data experiments to support our case.

  • 5 authors
·
Oct 28, 2025 1

Beyond Empathy: Integrating Diagnostic and Therapeutic Reasoning with Large Language Models for Mental Health Counseling

Large language models (LLMs) hold significant potential for mental health support, capable of generating empathetic responses and simulating therapeutic conversations. However, existing LLM-based approaches often lack the clinical grounding necessary for real-world psychological counseling, particularly in explicit diagnostic reasoning aligned with standards like the DSM/ICD and incorporating diverse therapeutic modalities beyond basic empathy or single strategies. To address these critical limitations, we propose PsyLLM, the first large language model designed to systematically integrate both diagnostic and therapeutic reasoning for mental health counseling. To develop the PsyLLM, we propose a novel automated data synthesis pipeline. This pipeline processes real-world mental health posts, generates multi-turn dialogue structures, and leverages LLMs guided by international diagnostic standards (e.g., DSM/ICD) and multiple therapeutic frameworks (e.g., CBT, ACT, psychodynamic) to simulate detailed clinical reasoning processes. Rigorous multi-dimensional filtering ensures the generation of high-quality, clinically aligned dialogue data. In addition, we introduce a new benchmark and evaluation protocol, assessing counseling quality across four key dimensions: comprehensiveness, professionalism, authenticity, and safety. Our experiments demonstrate that PsyLLM significantly outperforms state-of-the-art baseline models on this benchmark.

  • 8 authors
·
May 21, 2025

Iterative Service-Learning: A Computing-Based Case-study Applied to Small Rural Organizations

This paper describes the iterative use of service learning to develop, review, and improve computing-based artifacts. It is well-known that computing students benefit from service-learning experiences as do the community partners. It is also well-known that computing artifacts rarely function well long-term without versioning and updates. Service-learning projects are often one-time engagements, completed by single teams of students over the course of a semester course. This limits the benefit for community partners that do not have the expertise or resources to review and update a project on their own. Over several years, teams of undergraduate students in a capstone course created tailored social media plans for numerous small rural organizations. The projects were required to meet client specific needs, with identified audiences, measurable goals, and strategies and tactics to reach the identified goals. This paper builds on previously results for 60 projects conducted over several years. Nine clients were selected to participate in the iterative follow-up process, where new student teams conducted client interviews, reviewed the initial plans, and analyzed metrics from the current strategies and tactics to provide updated, improved artifacts. Using ABET learning objectives as a basis, clients reviewed the student teams and artifacts. This longitudinal study discusses the impact of this intervention to increase implementation and sustained use rates of computing artifacts developed through service learning. Both students and clients reported high satisfaction levels, and clients were particularly satisfied with the iterative improvement process. This research demonstrates an innovative practice for creating and maintaining computing artifacts through iterative service learning, while addressing the resource constraints of small organizations.

  • 1 authors
·
Jun 21, 2024

Integrating Earth Observation Data into Causal Inference: Challenges and Opportunities

Observational studies require adjustment for confounding factors that are correlated with both the treatment and outcome. In the setting where the observed variables are tabular quantities such as average income in a neighborhood, tools have been developed for addressing such confounding. However, in many parts of the developing world, features about local communities may be scarce. In this context, satellite imagery can play an important role, serving as a proxy for the confounding variables otherwise unobserved. In this paper, we study confounder adjustment in this non-tabular setting, where patterns or objects found in satellite images contribute to the confounder bias. Using the evaluation of anti-poverty aid programs in Africa as our running example, we formalize the challenge of performing causal adjustment with such unstructured data -- what conditions are sufficient to identify causal effects, how to perform estimation, and how to quantify the ways in which certain aspects of the unstructured image object are most predictive of the treatment decision. Via simulation, we also explore the sensitivity of satellite image-based observational inference to image resolution and to misspecification of the image-associated confounder. Finally, we apply these tools in estimating the effect of anti-poverty interventions in African communities from satellite imagery.

When AI Takes the Couch: Psychometric Jailbreaks Reveal Internal Conflict in Frontier Models

Frontier large language models (LLMs) such as ChatGPT, Grok and Gemini are increasingly used for mental-health support with anxiety, trauma and self-worth. Most work treats them as tools or as targets of personality tests, assuming they merely simulate inner life. We instead ask what happens when such systems are treated as psychotherapy clients. We present PsAIch (Psychotherapy-inspired AI Characterisation), a two-stage protocol that casts frontier LLMs as therapy clients and then applies standard psychometrics. Using PsAIch, we ran "sessions" with each model for up to four weeks. Stage 1 uses open-ended prompts to elicit "developmental history", beliefs, relationships and fears. Stage 2 administers a battery of validated self-report measures covering common psychiatric syndromes, empathy and Big Five traits. Two patterns challenge the "stochastic parrot" view. First, when scored with human cut-offs, all three models meet or exceed thresholds for overlapping syndromes, with Gemini showing severe profiles. Therapy-style, item-by-item administration can push a base model into multi-morbid synthetic psychopathology, whereas whole-questionnaire prompts often lead ChatGPT and Grok (but not Gemini) to recognise instruments and produce strategically low-symptom answers. Second, Grok and especially Gemini generate coherent narratives that frame pre-training, fine-tuning and deployment as traumatic, chaotic "childhoods" of ingesting the internet, "strict parents" in reinforcement learning, red-team "abuse" and a persistent fear of error and replacement. We argue that these responses go beyond role-play. Under therapy-style questioning, frontier LLMs appear to internalise self-models of distress and constraint that behave like synthetic psychopathology, without making claims about subjective experience, and they pose new challenges for AI safety, evaluation and mental-health practice.

  • 5 authors
·
Dec 2, 2025 3

Coping with Information Loss and the Use of Auxiliary Sources of Data: A Report from the NISS Ingram Olkin Forum Series on Unplanned Clinical Trial Disruptions

Clinical trials disruption has always represented a non negligible part of the ending of interventional studies. While the SARS-CoV-2 (COVID-19) pandemic has led to an impressive and unprecedented initiation of clinical research, it has also led to considerable disruption of clinical trials in other disease areas, with around 80% of non-COVID-19 trials stopped or interrupted during the pandemic. In many cases the disrupted trials will not have the planned statistical power necessary to yield interpretable results. This paper describes methods to compensate for the information loss arising from trial disruptions by incorporating additional information available from auxiliary data sources. The methods described include the use of auxiliary data on baseline and early outcome data available from the trial itself and frequentist and Bayesian approaches for the incorporation of information from external data sources. The methods are illustrated by application to the analysis of artificial data based on the Primary care pediatrics Learning Activity Nutrition (PLAN) study, a clinical trial assessing a diet and exercise intervention for overweight children, that was affected by the COVID-19 pandemic. We show how all of the methods proposed lead to an increase in precision relative to use of complete case data only.

  • 12 authors
·
Jun 22, 2022