The five-period crossover design for thorough QT studies can increase standard errors by up to 13% compared to the four-period design when realistic treatment correlations are considered.
The assumption that a five-period crossover TQT design reduces sample size is flawed because it ignores within-subject correlation, making the four-period design more efficient in practice.
https://doi.org/10.3205/mibe000306 | Chen L, Weng YT. Commentary on “An efficient crossover design for thorough QT studies” by Ring et al. GMS Med Inform Biom Epidemiol. 2026;22:Doc08.DOI: 10.3205/mibe000306URN: urn:nbn:de:0183-mibe0003061
Chen et al. (Fri,) conducted a letter in Thorough QT (TQT) studies. Five-period crossover design vs. Four-period crossover design was evaluated on Standard error ratio. The five-period crossover design for thorough QT studies can increase standard errors by up to 13% compared to the four-period design when realistic treatment correlations are considered.