A conventional randomised trial tests one intervention against a control, then closes. A platform trial keeps running: arms can be added as new candidate treatments appear and dropped once there is a clear answer, all under one master protocol.
RECOVERY
The RECOVERY trial, registered as NCT04381936, was set up in the United Kingdom in 2020 to test possible treatments for patients admitted to hospital with COVID-19. Its dexamethasone result, published in The New England Journal of Medicine, found lower 28-day mortality among patients who were receiving respiratory support, but no benefit among those who were not. Because the trial was large, simple and embedded in routine care, that answer arrived quickly and changed practice worldwide.
STAMPEDE
STAMPEDE applied a multi-arm, multi-stage design to advanced prostate cancer, comparing several treatment approaches against a shared control arm and stopping arms early when interim analyses showed they were unlikely to help. It shows that the efficiency of platform designs is not limited to emergencies.
Research on research
Trial methodology is itself an evidence-based field. Studies within a trial (SWATs), such as the WHEAT-Boost study of video-assisted consent in our research watch, randomise how a trial is run — recruitment, consent or retention — to find out what works. The Research Division treats this kind of work as central to its remit.