Evidence map›Paper›PMID 41870211›Full record

ArticlePediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2026

The Paediatric Intensive Care Adaptive Platform Trial (PIVOTAL): Turning Pediatric Critical Care Practice Into Clinical Research.

Mark J Peters, Paul Mouncey, Alexina Mason, Tasnin Shahid, Padmanabhan Ramnarayan, Samiran Ray, Katherine Brown, Irene Chang, Doug W Gould, David Harrison and 1 more

Abstract readClinical Trial Protocol
In one paragraph

Article in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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.

Mark J PetersPaediatric Intensive Care Unit, Great Ormond Street Hospital, London, United Kingdom.ORCID 0000-0003-3653-4808
Paul MounceyClinical Trials Unit, Intensive Care National Audit & Research Centre, London, United Kingdom.
Alexina MasonClinical Trials Unit, Intensive Care National Audit & Research Centre, London, United Kingdom.
Tasnin ShahidClinical Trials Unit, Intensive Care National Audit & Research Centre, London, United Kingdom.
Padmanabhan RamnarayanChildren's Acute Transport Service, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.
Samiran RayPaediatric Intensive Care Unit, Great Ormond Street Hospital, London, United Kingdom.
Katherine BrownCardiac Intensive Care Unit, Great Ormond Street Hospital, London, United Kingdom.
Irene ChangClinical Trials Unit, Intensive Care National Audit & Research Centre, London, United Kingdom.
Doug W GouldClinical Trials Unit, Intensive Care National Audit & Research Centre, London, United Kingdom.
David HarrisonClinical Trials Unit, Intensive Care National Audit & Research Centre, London, United Kingdom.
and the Paediatric Intensive Care Adaptive Platform Trial (PIVOTAL) investigators for Paediatric Critical Care Society Study Group (PCCS-SG)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo describe the rationale, design, and implementation of the Paediatric Intensive Care Adaptive Platform Trial (PIVOTAL), a novel approach to embed adaptive clinical research within routine pediatric critical care practice.

designProspective, multicenter, Bayesian adaptive platform trial developed by the U.K. Paediatric Critical Care Society Study Group (PCCS-SG) and funded by the U.K. National Institute for Health and Care Research Health Technology Assessment program.

settingA minimum of 20 of the 33 PICUs across the United Kingdom that participating in the PCCS-SG research network. PATIENTS: Critically ill children admitted to a PICU requiring support for one or more organ systems.

interventionsEligible patients will be randomized across multiple concurrent intervention domains. Each domain will test clinically relevant therapies where practice variation and evidence gaps exist. The adaptive Bayesian design allows dynamic modification of randomization ratios, dropping of inferior interventions, and addition of new domains over time. MEASUREMENTS AND MAIN

resultsThe primary outcome, common to all domains, is days alive and free of organ support to day 30. Trial efficiency and inclusivity are enhanced using routinely collected national registry data from the Paediatric Intensive Care Audit Network, real-time electronic health record integration, and a proportionate consent model. Extensive statistical simulations will inform decision rules for superiority, futility, and equivalence.

conclusionsPIVOTAL aims to bridge the gap between clinical care and research, providing a sustainable infrastructure to deliver timely, inclusive, and practice-changing evidence in pediatric critical care. Recruitment started in March 2026.

Indexed as

Biomedical ResearchCritical CareIntensive Care Units, PediatricBayes TheoremChildChild, PreschoolClinical Trials as TopicCritical IllnessHumansMulticenter Studies as TopicProspective StudiesResearch DesignUnited KingdomBayesianclinical researchmethodologyresearch networkstrials

Identifiers

PMID41870211
PMCPMC13218570

What Socratic holds

Textmetadata
LicenceCC BY
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 Socratic graph.