The assumption that neutral trials in critical care are a peculiar combination of perfectly balanced groups that neutralize themselves is, most if not all of the time, a fairy tale.
Book titles everywhere: "Neutral Tones in Interior Design"
Book titles in North America: "Beige: The Color That Conquered the Suburbs, Destroyed Joy, and United a Fractured Republic"
Canadian Vigour Center (www.thecvc.ca) officially launched the #HEART platform trial, a platform trial for patients living with heart failure. First pilot trial on ketone supplementation to start soon.
A fellowship position is also posted.
www.heartplatform.ca
Literature is warming up and extending e-values to platform trials seems the logical next step.
This will allow continuous monitoring of clinical trials while controlling type I error.
arxiv.org/abs/2602.06379
arxiv.org/abs/2512.04366
arxiv.org/abs/2606.00878
An e-value is the payoff of a $1 bet against the null. Formally: E ≥ 0 with E[E] ≤ 1 if the null is true. Big E = the null lost money = evidence against it. Bonus: e-values multiply across studies and stay valid even if you peek and stop early. The p-value can't do that.
The overall concept is simple. In a fair betting game, knowing previous outcomes shouldn't allow you to make better bets in future draws. If it does, the null hypothesis is false.
arxiv.org/abs/2410.23614
Sequential-anytime valid inference refers to methods that guarantee anytime validity and type I error control even with infinite looks. It is entrenched in Markov's and Ville's inequalities and comes from game theory. Major companies use it (Netflix included).
I have few doubts that sequential-anytime valid inference (SAVI) and e-values will reach clinical trials space soon.
What is SAVI and what are e-values? And why should you care?