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Adaptive platform trials and PIVOTAL
- Professor Kathy RowanFounder and Scientific Advisor at ICNARC
Key points
- An adaptive platform trial evaluates a number of interventions on a single trial platform rather than looking at one intervention in isolation.
- Patients are randomised to combinations of the interventions they are eligible for, which is a very efficient way of delivering research.
- The hope is that this will generate evidence on the best treatments sooner for sick children, and early data show the community delivering on the PIVOTAL trial.
Professor Kathy Rowan, Founder and Scientific Advisor at ICNARC, provides insights into the future of paediatric critical care research through adaptive platform trials. She explains how a single trial platform can evaluate several interventions and eligible combinations, offering a more efficient approach than studying each treatment in isolation. The interview discusses PIVOTAL and the potential for this model to help generate evidence about care for critically ill children more quickly. Professor Rowan also reflects on the collective contribution of the paediatric critical care community and the collaborative delivery that underpins this next stage of clinical research.
This interview took place at the PCCS Annual Scientific Meeting 2026 in London.
Read the transcript
Automatic transcript, lightly edited for readability. It may contain errors, so check it against the video before quoting.
So I talked a little bit about thinking about what the future looks like, and the paediatric critical care community has just been awarded, well earned in terms of competitive proposals, an adaptive platform trial. This is a really important development in trial methodology where on a single trial platform you evaluate a number of interventions.
So rather than just looking at one intervention in isolation, you actually randomise patients to combinations of interventions that they're eligible for. That means it's a very efficient way of delivering research. It means that I hope that we will generate research evidence on best treatments sooner, quicker for sick children to achieve best outcomes.
And unsurprisingly, the early data show that the paediatric critical care community are delivering over and above on the PIVOTAL trial. And it's phenomenal to see the collective output and activity of this wonderful group of people.
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Cite this video
Professor Kathy Rowan. “Adaptive platform trials and PIVOTAL.” The Paediatric Video Journal, 7 November 2026. https://paediatricvj.com/videos/adaptive-platform-trials-and-pivotal-rowan/
This interview is educational content intended for healthcare professionals and is not medical advice. Views expressed are those of the speaker. © The Paediatric Video Journal. All rights reserved.