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August 20, 2026 article Open access Aachen paper

Modernizing evidence generation for clinical artificial intelligence: the case for adaptive platform trials

npj Digital Medicine

DOI: 10.1038/s41746-026-03154-8 Full text (OA) OpenAlex

Abstract

Traditional diagnostic and prognostic trials cannot keep pace with rapidly evolving clinical artificial intelligence (AI) systems, particularly generative tools and continuously updating models. Adaptive platform trials offer a scalable framework for continuous, comparative, equity-focused evaluation by testing multiple AI tools and updates head-to-head within a master protocol that standardizes populations, endpoints, decision rules, and governance, while allowing dynamic addition or removal of arms and reuse of control groups.

Authors 7

  1. Davy van de Sande

    Erasmus MC

    Affiliation as printed

    Department of Adult Intensive Care, Erasmus MC University Medical Center, Rotterdam, The Netherlands

    Erasmus MC Datahub, University Center Rotterdam, Rotterdam, The Netherlands

  2. Imke Bloemen

    Erasmus MC

    Affiliation as printed

    Department of Adult Intensive Care, Erasmus MC University Medical Center, Rotterdam, The Netherlands

    Erasmus MC Datahub, University Center Rotterdam, Rotterdam, The Netherlands

  3. Stefan Sleijfer

    Erasmus MC · Erasmus MC Cancer Institute

    Affiliation as printed

    Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands

    Executive Board, Erasmus MC, Rotterdam, The Netherlands

  4. M. Arfan Ikram Aachen Department of Clinical Epidemiology

    Harvard University · Leiden University Medical Center · Erasmus MC

    Affiliation as printed

    Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

    Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands

    Department of Epidemiology, Harvard Chan School of Public Health, Boston, MA, USA

  5. Lotty Hooft

    Utrecht University · University Medical Center Utrecht

    Affiliation as printed

    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands

  6. Diederik Gommers

    Erasmus MC

    Affiliation as printed

    Department of Adult Intensive Care, Erasmus MC University Medical Center, Rotterdam, The Netherlands

    Erasmus MC Datahub, University Center Rotterdam, Rotterdam, The Netherlands

  7. Michel E. van Genderen corresponding

    Duke University · Erasmus MC · Duke Medical Center

    Affiliation as printed

    Department of Adult Intensive Care, Erasmus MC University Medical Center, Rotterdam, The Netherlands

    Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA

    Erasmus MC Datahub, University Center Rotterdam, Rotterdam, The Netherlands

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