Titration of a combination of drugs or treatment modalities within
individual subjects is carried out using an evolutionary operation (EVOP)
direct-search procedure such as the Nelder-Mead simplex. Desirability
functions are incorporated to define the main response of interest and
additional responses or constraints. Statistical methodology for
determining whether the titrated treatment combination has resulted in an
improvement in patient response and for evaluating whether a therapeutic
synergism exists is also incorporated. Inferences can be made about the
efficacy of the combination or about the individual drugs or treatment
modalities that comprise the combination. This approach allows every
patient the potential to benefit from the combination under study and
permits the consideration of multiple endpoints simultaneously.