Evidence map›Paper›PMID 42109297›Full record

ReviewOsteoarthritis and cartilage open2026

Adaptive trials in low back pain and osteoarthritis: How common are they and when should they be used? A systematic review from ClinicalTrials.gov.

Anelise Moreti Cabral Silveira, Michelle Wang, Michelle Hall, Manuela L Ferreira, Paula R Beckenkamp, Thomas Snelling, Serigne N Lo, Laurent Billot, James M S Wason, Haiyan Zheng and 1 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Osteoarthritis and cartilage open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Anelise Moreti Cabral SilveiraFaculty of Medicine and Health, Sydney Musculoskeletal Health, The University of Sydney, Sydney, New South Wales (NSW), Australia.
Michelle WangFaculty of Medicine and Health, Sydney Musculoskeletal Health, The University of Sydney, Sydney, New South Wales (NSW), Australia.
Michelle HallMusculoskeletal Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales (NSW), Australia.
Manuela L FerreiraThe George Institute for Global Health, UNSW Sydney, Sydney, New South Wales (NSW), Australia.
Paula R BeckenkampFaculty of Medicine and Health, Sydney Musculoskeletal Health, The University of Sydney, Sydney, New South Wales (NSW), Australia.
Thomas SnellingSydney School of Public Health, The University of Sydney, Sydney, New South Wales (NSW), Australia.
Serigne N LoFaculty of Medicine and Health, The University of Sydney, Sydney, New South Wales (NSW), Australia.
Laurent BillotThe George Institute for Global Health, UNSW Sydney, Sydney, New South Wales (NSW), Australia.
James M S WasonPopulation Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom.
Haiyan ZhengDepartment of Mathematical Sciences, University of Bath, Bath, United Kingdom.
Paulo H FerreiraFaculty of Medicine and Health, Sydney Musculoskeletal Health, The University of Sydney, Sydney, New South Wales (NSW), Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: This registry-based systematic review aimed to investigate the use and applicability of adaptive designs in ongoing low back pain (LBP) and osteoarthritis (OA) trials and discuss emerging opportunities of adaptive designs in the field, in light of the expected advantages and possible challenges. Method: We searched ClinicalTrials.gov for records of ongoing studies in chronic LBP or OA. The applicability of adaptive designs for the included trials was assessed based on the ratio of primary endpoint length to recruitment length, considering a ratio below 0.25 as an indicator of potential feasibility. Meeting this ratio means there may be opportunities to implement adaptations that improve trial efficiency and benefit participants yet to be recruited. Results: Overall, 579 clinical trials were included (135 trials in LBP and 447 trials in OA, with three overlapping studies among the two conditions). A ratio below 0.25 was observed in 89 (66%) LBP trials and 256 (57%) OA trials, suggesting they could potentially benefit from an adaptive design. However, only two (1.5%) out of 135 LBP trials and eight (1.8%) out of 447 OA trials reported an adaptive design, with the most common types being dose escalation studies (67%), followed by group-sequential designs (22%), and master protocols (11%). Conclusion: The use of adaptive designs in LBP and OA clinical trials is rare, although many trials would benefit from using this innovative approach to trial conduct. Researchers should be encouraged to consider the benefits and challenges of employing an adaptive design to plan future trials.

Indexed as

Adaptive designClinical trialMusculoskeletalRandomised controlled trialRegistry-based reviewSpine

Identifiers

PMID42109297
PMCPMC13157151

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.