Platform trials for anaesthesia and perioperative medicine: a narrative review

Large randomised trials provide the most reliable evidence of effectiveness of new treatments in clinical practice. However, the time and resources required to complete such trials can be daunting. An overarching clinical trial platform focused on a single condition or type of surgery, aiming to compare several treatments, with an option to stop any or add in new treatment options, can provide greater efficiency. This has the potential to accelerate knowledge acquisition and identify effective, ineffective, or harmful treatments faster. The master protocol of the platform defines the study population(s) and standardised procedures. Ineffective or harmful treatments can be discarded or study drug dose modified during the life cycle of the trial. Other adaptive elements that can be modified include eligibility criteria, required sample size for any comparison(s), randomisation assignment ratio, and the addition of other promising treatment options. There are excellent opportunities for anaesthetists to establish platform trials in perioperative medicine. Platform trials are highly efficient, with the potential to provide quicker answers to important clinical ques-tions that lead to improved patient care.

Automated summary

Large randomised trials are the most reliable way to assess new treatments in clinical practice, but they can be time-consuming and resource-intensive. A clinical trial platform focused on a specific condition or surgery type can increase efficiency by comparing multiple treatments and allowing for changes during the trial. This can speed up knowledge acquisition and identify effective or harmful treatments faster. Platform trials have great potential in perioperative medicine to provide quicker answers to important clinical questions and improve patient care.