Alternative designs for randomized clinical trials

Hip fractures present some of the biggest challenges facing patients and healthcare systems. Worldwide, there are currently 1.3 million hip fractures per year, projected to rise to more than six million by 2050. The World Hip Trauma Evaluation (WHiTE) platform trial will provide randomized evidence dealing with the clinical and cost-effectiveness of interventions to improve outcomes for patients with a fragility fracture of the hip. The previous WHiTE cohort multiple-embedded trials’ model was highly successful in delivering evidence to inform national and international policy and practice guidelines. This annotation addresses two questions: why change to a platform trial design? And what are the potential advantages and disadvantages of trials which use newer methodologies? Cite this article: Bone Joint J 2025;107-B(8):772–776.