This narrative review assesses Bayesian methods in clinical trials, suggesting careful justification and alternative approaches when necessary.
Among the reasons given for choosing Bayesian methods, we consider the use of informative priors or making direct probability statements to be the strongest motivations for a Bayesian analysis, because there are no equivalent frequentist approaches. Making direct probability statements was the most common motivation provided, while informative priors were not often used. In settings with recruitment difficulties, we recommend considering borrowing relevant information, to gain power and precision. In all confirmatory trial settings, we recommend that Bayesian approaches are used only with careful justification, investigators make clear whether the methods and priors were pre-planned, and alternative frequentist approaches are considered.
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Turner et al. (2026) studied this question.
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