NSW Adaptive Platform Trials

Project summary An initiative to improve NSW capacity and capability to conduct adaptive clinical trials for the treatment of COVID-19. What is the issue for NSW? COVID-19 has brought into sharp focus the urgent need for up-to-date, evidence-informed decision making. Recognition that traditional randomised trials (RCTs) are not providing the evidence we need, and are too difficult to conduct during a pandemic, has prompted many countries to accelerate the move to Adaptive Platform Trials that can be embedded into routine care. In NSW, supporting and extending existing international and Platforms that span the COVID-19 disease spectrum, is essential to providing evidence-based treatment options for patients, clinicians and the health system. Platforms for COVID-19 include: REMAP-CAP (ICU), ASCOT (in-hospital) and BEAT-COVID (in-community). In collaboration with these Adaptive Platforms, developing and expanding selected research networks to be 'trial ready' provides a coordinated approach to trials participation, ensures all COVID-19 patients in NSW have access to clinical trials and places NSW at the leading edge of COVID-19 research. What does the research aim to do and how? The NSW Adaptive Platform Trials aim to deliver: rapid and efficient assessments of COVID-19 models of care and interventions improved understanding of the natural history of the disease, the biological response and therapeutics options to deliver quality evidence for decision making at the health system and clinical levels harmonisation of COVID-19 research across the care continuum in NSW remove competition for COVID-19 positive cases, ensuring trials can fully recruit the required number of participants to generate relevant evidence embed COVID-19 Platforms into routine care minimises disruption and cost of clinical trials to the health .