Simulation study demonstrates minimal impact of data-dependent interim monitoring adjustments on Type I error in clinical trials, suggesting flexible review schedules remain practically viable.
In clinical trial data monitoring, one can either introduce a discrete sequential boundary for a set of specified decision times or adopt a use function and then derive the boundary when data are monitored. If the use function approach is employed, one can adjust the frequency of data monitoring as long as the decision is not data-dependent. However, if the frequency of future data monitoring is affected by the observed data, then the probability of Type I error will no longer be preserved exactly. But the effect on the significance level and power is very small, perhaps negligible, as indicated by simulation results.
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Lan et al. (1989) studied this question.
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