Can our children’s trials work better than they do?

We’re all well aware of the problems of doing randomised clinical trials in paediatrics——but are we as aware of some alternative approaches that have been used1

‘Sequential design’ studies look at comparing a series of treatments against each other, switching to the ‘better’ arm and comparing against the next candidate as time progresses. They need quickly and easily available outcomes and tend to be usable only for short-course treatments but they’ve been estimated to reduce sample sizes by about 25%.

‘Adaptive design’ begins by pitting all the contenders against …