Balance and randomness in sequential clinical trials: the dominant biased coin design

Efron’s biased coin design (BCD) is a well-known randomization technique that helps neutralize selection bias, while keeping the experiment fairly balanced for every sample size. Several extensions of this rule have been proposed, and their properties were analyzed from an asymptotic viewpoint and compared via simulations in a finite setup. The aim of this paper is to push forward these comparisons by taking also into account the adjustable BCD, which is never considered up to now. Firstly, we show that the adjustable BCD performs better than Efron’s coin with respect to both loss of precision and randomness. Moreover, the adjustable BCD is always more balanced than the other coins and, only for some sample sizes, slightly more predictable. Therefore, we suggest the dominant BCD, namely a new and flexible class of procedures that can change the allocation rule step by step in order to ensure very good performance in terms of both balance and selection bias for any sample size. Our simulations demonstrate that the dominant BCD is more balanced and, at the same time, less or equally predictable than Atkinson’s optimum BCD.