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While efficient, the efficacy of international platform trials in getting sound results on COVID-19 was called into question by NIH statisticians.
This type of randomized clinical trial (RCT) skips a lot of the time-consuming work of setting up separate trials. Instead, multiple experimental treatment groups are compared with a single control group and experimental arms can enter and exit the trial at different times as evidence emerges.
Large pragmatic platform trials have been behind most of the successes in finding treatments for COVID-19, including the RECOVERY and REMAP-CAP trials.
However, this feature that leads to the speed useful in a pandemic can also undermine the key tenet of RCTs: that randomization yields equivalent patient populations so that between-group differences can be attributed solely to the treatment.