{"doi":"10.1214/23-sts865c","title":"Comment: Advancing Clinical Trials with Novel Designs and Implementations","abstract":"We extend our congratulations to Robertson and coauthors [12] for their comprehensive overview of response adaptive randomization (RAR) in clinical trials and insightful comparative analyses.Their contribution is noteworthy for clearly demonstrating the diversity of RAR designs and algorithms that utilize the available data to update randomization probabilities throughout the enrollment period.For instance, several forms of Bayesian RAR tend to accelerate the enrollment to the most promising arms, while other RAR strategies vary the randomization probabilities to enhance trial power compared to fixed or balanced randomization.The authors accurately highlight the wide range of statistical designs based on RAR, each with different benefits and risks compared to balanced randomization.The significance of showing marked differences of the operating characteristics of various RAR designs lies in the fact that the views of stakeholders, including biostatisticians and clinical trial investigators, on the key aspects of RAR are often influenced by their experience with a single algorithm, a narrow subset of RAR designs explored in a publication or a few RAR clinical trials with favorable or unfavorable patient allocation.Such biases can obstruct the development of effective clinical trial designs.Additionally, it is essential to consider the broad range of settings where RAR and adaptive trial designs can be utilized in clinical research.Context-specific evaluations of RAR designs are necessary as their advantages and disadvantages over traditional randomization vary with study-specific factors such as the expected accrual rate or the risk of time trends of the enrolled population.To fully assess the potential of RAR and adaptive trial designs, it is crucial to account for these context-specific considerations.In our experience with adaptive platform trials [1,5,19], it is necessary to consider both operational/implementation complexity and potential efficiencies over fixed randomization.A relevant aspect of RAR that is often overlooked is the possibility of reducing the number of patients allocated to inferior arms.Early in the trial, data may suggest that","journal":"Statistical Science","year":2023,"id":408229,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9626,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":372059,"name":"Yanxun Xu","orcid":"0000-0001-5554-8637","position":1,"is_corresponding":false},{"id":250470,"name":"Lorenzo Trippa","orcid":"0000-0001-5218-5666","position":0,"is_corresponding":true}],"reference_count":18,"raw_metadata":null,"created_at":"2026-07-19T01:21:14.562812Z","pmid":"37654478","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}