Pub Date : 2026-03-01Epub Date: 2026-02-03DOI: 10.1016/j.cct.2026.108251
Jeffrey Thiboutot , Ardian Latifi , Peter Illei , Christopher M. Kapp , Fabien Maldonado , Sonali Sethi , Scott Shofer , Christopher Gilbert , Momen Wahidi , Andrew DeMaio , Ashutosh Sachdeva , David DiBardino , Anil Vachani , Nicholas Pastis , Daniela Molena , Miranda R. Jones , Najib M. Rahman , Gerard Silvestri , Lonny Yarmus
Background
Transbronchial biopsy is a common bronchoscopic procedure that is traditionally performed with forceps. However, its diagnostic capability is limited by small specimen size and crush artifact. A 1.1 mm cryoprobe was developed to overcome these limitations utilizing rapid, controlled, freezing to retrieve larger specimens which are extractable through the bronchoscope's working channel. Whether this improves diagnostic yield remains uncertain. The 1.1 mm cryoprobe has not been directly compared to standard capacity forceps in a prospective, randomized fashion.
Methods
This multicenter randomized controlled trial evaluates whether transbronchial biopsy with a 1.1 mm cryoprobe yields superior diagnostic yield compared to standard capacity forceps in adults undergoing transbronchial biopsy for diffuse parenchymal lung disease, parenchymal pulmonary lesions, or lung allografts. Participants will be randomized 1:1 to either biopsy tool, stratified by indication. Primary outcomes include indication-specific and overall diagnostic yield, adjudicated by centralized pathology review. Secondary outcomes include histologic quality metrics and complication rates. This trial is individually powered for each indication-specific primary outcome, and can detect an 11.3% difference in overall diagnostic yield with 250 participants per arm.
Discussion
This trial will provide high-quality evidence to guide transbronchial biopsy tool selection to maximize diagnostic yield. Results of this trial may yield practice changing data for the evaluation of patients with diffuse parenchymal lung disease, parenchymal pulmonary lesions, and lung allografts. Unique design features include the use of a centralized histopathology core to minimize bias and interobserver variability and a pragmatic design to facilitate integration into clinical workflows and optimize recruitment.
{"title":"A randomized controlled trial of cryoprobe versus forceps for transbronchial biopsy (FROSTBITE-2): Study protocol for a multi-center pragmatic clinical trial","authors":"Jeffrey Thiboutot , Ardian Latifi , Peter Illei , Christopher M. Kapp , Fabien Maldonado , Sonali Sethi , Scott Shofer , Christopher Gilbert , Momen Wahidi , Andrew DeMaio , Ashutosh Sachdeva , David DiBardino , Anil Vachani , Nicholas Pastis , Daniela Molena , Miranda R. Jones , Najib M. Rahman , Gerard Silvestri , Lonny Yarmus","doi":"10.1016/j.cct.2026.108251","DOIUrl":"10.1016/j.cct.2026.108251","url":null,"abstract":"<div><h3>Background</h3><div>Transbronchial biopsy is a common bronchoscopic procedure that is traditionally performed with forceps. However, its diagnostic capability is limited by small specimen size and crush artifact. A 1.1 mm cryoprobe was developed to overcome these limitations utilizing rapid, controlled, freezing to retrieve larger specimens which are extractable through the bronchoscope's working channel. Whether this improves diagnostic yield remains uncertain. The 1.1 mm cryoprobe has not been directly compared to standard capacity forceps in a prospective, randomized fashion.</div></div><div><h3>Methods</h3><div>This multicenter randomized controlled trial evaluates whether transbronchial biopsy with a 1.1 mm cryoprobe yields superior diagnostic yield compared to standard capacity forceps in adults undergoing transbronchial biopsy for diffuse parenchymal lung disease, parenchymal pulmonary lesions, or lung allografts. Participants will be randomized 1:1 to either biopsy tool, stratified by indication. Primary outcomes include indication-specific and overall diagnostic yield, adjudicated by centralized pathology review. Secondary outcomes include histologic quality metrics and complication rates. This trial is individually powered for each indication-specific primary outcome, and can detect an 11.3% difference in overall diagnostic yield with 250 participants per arm.</div></div><div><h3>Discussion</h3><div>This trial will provide high-quality evidence to guide transbronchial biopsy tool selection to maximize diagnostic yield. Results of this trial may yield practice changing data for the evaluation of patients with diffuse parenchymal lung disease, parenchymal pulmonary lesions, and lung allografts. Unique design features include the use of a centralized histopathology core to minimize bias and interobserver variability and a pragmatic design to facilitate integration into clinical workflows and optimize recruitment.</div></div>","PeriodicalId":10636,"journal":{"name":"Contemporary clinical trials","volume":"162 ","pages":"Article 108251"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-04DOI: 10.1016/j.cct.2026.108252
Emerson M. Wickwire , Vincent F. Capaldi II , Jennifer Y. So , Eungjae Kim , Connie Thomas , Christine W. Johnston , Sarah Maggio , Joshua S. Elmore , Jennifer S. Albrecht , Avelino C. Verceles , Shuo Chen
Background
Obstructive sleep apnea (OSA) is common and costly in the U.S. military health system (MHS). OSA is associated with poor health outcomes as well as increased economic burden borne by the Defense Health Agency. The MHS lacks the capacity to meet the available demand for sleep specialty care. Thus, most military OSA care is provided by private sector TRICARE-contracted civilian providers. Given the burden of OSA and limited access to OSA care, optimizing OSA care within the MHS is vital. TELE-SLEEP OSA is a randomized, parallel group, single blind, controlled clinical trial comparing OSA telehealth care to standard private sector TRICARE.
Methods
Participants will include 160 active-duty family members and Defense Enrollment Eligibility Reporting System beneficiaries who are referred for OSA consultation. Following informed consent, participants will complete baseline assessments prior to randomization. Participants randomized to private sector TRICARE will receive treatment as usual, including positive airway pressure (PAP) therapy. Participants randomized to OSA telehealth care will undergo telehealth consultation with a board-certified sleep medicine specialist, undergo home sleep apnea testing, receive auto-titrating PAP therapy, and receive ongoing support from educator-level sleep navigators throughout the study. Quantitative follow-up assessments will be completed at 30 and 90 days after treatment initiation. Qualitative focus groups to assess participant satisfaction and other implementation outcomes will be conducted with participants from both treatment groups. Outcomes include PAP adherence (primary outcome), OSA symptoms, implementation, and cost-effectiveness.
Conclusion
Our telemedicine approach to OSA treatment aims to reduce costs and improve health outcomes within the MHS.
{"title":"TELE-SLEEP OSA: A protocol for a hybrid type I randomized clinical trial of telemedicine for obstructive sleep apnea among military dependents and retirees","authors":"Emerson M. Wickwire , Vincent F. Capaldi II , Jennifer Y. So , Eungjae Kim , Connie Thomas , Christine W. Johnston , Sarah Maggio , Joshua S. Elmore , Jennifer S. Albrecht , Avelino C. Verceles , Shuo Chen","doi":"10.1016/j.cct.2026.108252","DOIUrl":"10.1016/j.cct.2026.108252","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive sleep apnea (OSA) is common and costly in the U.S. military health system (MHS). OSA is associated with poor health outcomes as well as increased economic burden borne by the Defense Health Agency. The MHS lacks the capacity to meet the available demand for sleep specialty care. Thus, most military OSA care is provided by private sector TRICARE-contracted civilian providers. Given the burden of OSA and limited access to OSA care, optimizing OSA care within the MHS is vital. TELE-SLEEP OSA is a randomized, parallel group, single blind, controlled clinical trial comparing OSA telehealth care to standard private sector TRICARE.</div></div><div><h3>Methods</h3><div>Participants will include 160 active-duty family members and Defense Enrollment Eligibility Reporting System beneficiaries who are referred for OSA consultation. Following informed consent, participants will complete baseline assessments prior to randomization. Participants randomized to private sector TRICARE will receive treatment as usual, including positive airway pressure (PAP) therapy. Participants randomized to OSA telehealth care will undergo telehealth consultation with a board-certified sleep medicine specialist, undergo home sleep apnea testing, receive auto-titrating PAP therapy, and receive ongoing support from educator-level sleep navigators throughout the study. Quantitative follow-up assessments will be completed at 30 and 90 days after treatment initiation. Qualitative focus groups to assess participant satisfaction and other implementation outcomes will be conducted with participants from both treatment groups. Outcomes include PAP adherence (primary outcome), OSA symptoms, implementation, and cost-effectiveness.</div></div><div><h3>Conclusion</h3><div>Our telemedicine approach to OSA treatment aims to reduce costs and improve health outcomes within the MHS.</div></div><div><h3>Clinical trial registration</h3><div><span><span>NCT07121452</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10636,"journal":{"name":"Contemporary clinical trials","volume":"162 ","pages":"Article 108252"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146130608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-21DOI: 10.1016/j.cct.2026.108242
Polly-Anna Ashford , Stanley Musgrave , Allan B. Clark , Susan Stirling , Martin Pond , David Price , Francis Appiagyei , Estelle Payerne , Jane R. Smith , Michael Noble , Andrew M. Wilson
Electronic health record data holds great potential for conducting large, efficient randomised controlled trials. Despite progress towards greater availability of linked NHS datasets, the use of routine clinical data remains challenging for trialists. In this paper we describe the design, adaptations and implementation of methods for data collection and linkage in ARRISA-UK: a cluster-randomised controlled trial of a complex asthma management intervention involving 275 primary care practices across England, Wales and Scotland.
Our methods were designed to build a dataset of linked primary care and secondary care data for approximately 10,000 ‘at-risk’ asthma patients to measure the trial's primary outcome (asthma crisis events comprising respiratory-related hospital admissions, emergency department attendances and/or death for ‘at-risk’ asthma patients) and secondary clinical outcomes including the impact of the intervention on ∼180,000 asthma patients at participating practices.
A high level of practice attrition (33%) was observed due to data extraction delays and technical barriers, patient identification errors, and concerns about the processing of patient identifiable data for the purpose of record linkage. We highlight the technical achievements, barriers and lessons learned from ARRISA-UK and propose recommendations to facilitate future data-enabled trials, including greater resourcing in recognition of their complex nature, improved systems of support and training in primary care, and the need to maintain and improve clinician and public trust in research data use for long term sustainability.
{"title":"Design and implementation of data collection and linkage of electronic health records in a large UK cluster-randomised trial of asthma management (ARRISA-UK)","authors":"Polly-Anna Ashford , Stanley Musgrave , Allan B. Clark , Susan Stirling , Martin Pond , David Price , Francis Appiagyei , Estelle Payerne , Jane R. Smith , Michael Noble , Andrew M. Wilson","doi":"10.1016/j.cct.2026.108242","DOIUrl":"10.1016/j.cct.2026.108242","url":null,"abstract":"<div><div>Electronic health record data holds great potential for conducting large, efficient randomised controlled trials. Despite progress towards greater availability of linked NHS datasets, the use of routine clinical data remains challenging for trialists. In this paper we describe the design, adaptations and implementation of methods for data collection and linkage in ARRISA-UK: a cluster-randomised controlled trial of a complex asthma management intervention involving 275 primary care practices across England, Wales and Scotland.</div><div>Our methods were designed to build a dataset of linked primary care and secondary care data for approximately 10,000 ‘at-risk’ asthma patients to measure the trial's primary outcome (asthma crisis events comprising respiratory-related hospital admissions, emergency department attendances and/or death for ‘at-risk’ asthma patients) and secondary clinical outcomes including the impact of the intervention on ∼180,000 asthma patients at participating practices.</div><div>A high level of practice attrition (33%) was observed due to data extraction delays and technical barriers, patient identification errors, and concerns about the processing of patient identifiable data for the purpose of record linkage. We highlight the technical achievements, barriers and lessons learned from ARRISA-UK and propose recommendations to facilitate future data-enabled trials, including greater resourcing in recognition of their complex nature, improved systems of support and training in primary care, and the need to maintain and improve clinician and public trust in research data use for long term sustainability.</div></div>","PeriodicalId":10636,"journal":{"name":"Contemporary clinical trials","volume":"162 ","pages":"Article 108242"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146036459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-20DOI: 10.1016/j.cct.2026.108229
Anabel de la Rosa Gómez , Pablo D. Valencia , Dulce M. Díaz Sosa , Lorena Alejandra Flores Plata , Raquel García Flores , Carolina Santillán Torres Torija , Alejandra Mares Portillo , Alfonso Mendoza Leal , Alicia Ivet Flores Elvira , Esteban Eugenio Esquivel-Santoveña , Enrique Berra Ruiz
Objective
There is strong evidence that online transdiagnostic interventions are effective in treating anxiety and depression, and contribute to improving patients' quality of life. This study aimed to evaluate the efficacy and acceptability of an internet-guided transdiagnostic intervention (guided UP) versus a self-guided internet-based transdiagnostic intervention (unguided UP) for the transdiagnostic treatment of emotional disorders targeting the Mexican community.
Methods
A randomized clinical trial was conducted to compare therapist-supported online transdiagnostic treatment with an unguided version and a waiting list control group. 247 individuals aged 18 to 70 years were assessed at four time points (before and after treatment, three and six months follow- up) to identify levels of anxiety, depression, trauma and stress-related symptoms. Participants who qualified and decided to participate were randomly assigned to one of three conditions.
Results
Higher levels of acceptability, satisfaction, and suitability were reported for the intervention with therapeutic support compared to the UP-unguided condition. After treatment, significant mean differences were found between the waitlist group and both the UP-guided and unguided groups in anxiety, depression, trauma and stress-related symptoms, and general distress, as well as in emotional dysregulation for the guided group only, all with large effect sizes. Direct comparisons between the UP-guided and unguided groups showed significant differences favoring the UP-guided treatment at post-test for depression and emotional dysregulation. However, at the 3- and 6-month follow-ups, the UP-unguided group continued to improve, whereas the UP-guided group tended to remain stable. As a result, by the end of the follow-up period, the UP-unguided group showed significantly lower levels of anxiety, PTSD symptoms, and emotional dysregulation.
Conclusions
The study supports the preliminary evidence of the clinical utility of UP online interventions in a specific sample recruited for the treatment of anxiety, depression, trauma and stress-related symptoms with the advantage of reaching a larger number of people. Even though the UP-unguided intervention showed clinical utility, the support of a therapist in an online intervention could offer an advantage that improves treatment adherence and, in particular, resulted in a greater reduction in symptoms of depression and emotional dysregulation, making it the superior option from a clinical perspective.
{"title":"Efficacy of a transdiagnostic guided internet-delivered intervention for anxiety, depression, trauma and stress-related symptoms: A randomized controlled trial","authors":"Anabel de la Rosa Gómez , Pablo D. Valencia , Dulce M. Díaz Sosa , Lorena Alejandra Flores Plata , Raquel García Flores , Carolina Santillán Torres Torija , Alejandra Mares Portillo , Alfonso Mendoza Leal , Alicia Ivet Flores Elvira , Esteban Eugenio Esquivel-Santoveña , Enrique Berra Ruiz","doi":"10.1016/j.cct.2026.108229","DOIUrl":"10.1016/j.cct.2026.108229","url":null,"abstract":"<div><h3>Objective</h3><div>There is strong evidence that online transdiagnostic interventions are effective in treating anxiety and depression, and contribute to improving patients' quality of life. This study aimed to evaluate the efficacy and acceptability of an internet-guided transdiagnostic intervention (guided UP) versus a self-guided internet-based transdiagnostic intervention (unguided UP) for the transdiagnostic treatment of emotional disorders targeting the Mexican community.</div></div><div><h3>Methods</h3><div>A randomized clinical trial was conducted to compare therapist-supported online transdiagnostic treatment with an unguided version and a waiting list control group. 247 individuals aged 18 to 70 years were assessed at four time points (before and after treatment, three and six months follow- up) to identify levels of anxiety, depression, trauma and stress-related symptoms. Participants who qualified and decided to participate were randomly assigned to one of three conditions.</div></div><div><h3>Results</h3><div>Higher levels of acceptability, satisfaction, and suitability were reported for the intervention with therapeutic support compared to the UP-unguided condition. After treatment, significant mean differences were found between the waitlist group and both the UP-guided and unguided groups in anxiety, depression, trauma and stress-related symptoms, and general distress, as well as in emotional dysregulation for the guided group only, all with large effect sizes. Direct comparisons between the UP-guided and unguided groups showed significant differences favoring the UP-guided treatment at post-test for depression and emotional dysregulation. However, at the 3- and 6-month follow-ups, the UP-unguided group continued to improve, whereas the UP-guided group tended to remain stable. As a result, by the end of the follow-up period, the UP-unguided group showed significantly lower levels of anxiety, PTSD symptoms, and emotional dysregulation.</div></div><div><h3>Conclusions</h3><div>The study supports the preliminary evidence of the clinical utility of UP online interventions in a specific sample recruited for the treatment of anxiety, depression, trauma and stress-related symptoms with the advantage of reaching a larger number of people. Even though the UP-unguided intervention showed clinical utility, the support of a therapist in an online intervention could offer an advantage that improves treatment adherence and, in particular, resulted in a greater reduction in symptoms of depression and emotional dysregulation, making it the superior option from a clinical perspective.</div></div>","PeriodicalId":10636,"journal":{"name":"Contemporary clinical trials","volume":"162 ","pages":"Article 108229"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146028602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-17DOI: 10.1016/j.cct.2026.108221
C.P. Ku , Alex Christian , Emerson Delacroix , Kirsten Trzeciak , Ken Resnicow , Sarah Bailey , Barbara Israel , Felix Valbuena , Susie Williamson
Background
Marginalized communities have been disproportionately impacted by COVID-19. In Michigan as of 2024, while 59% of Hispanic people, 46% of African American people, and 56% of White people received at least one dose of vaccine, only 8% of African American and 8% of Hispanic residents report being up-to-date, per CDC definition, compared to 13% of White residents. The goals of the project were to increase vaccine uptake through the implementation and evaluation of a tailored behavioral intervention.
Methods
This group-tailored digital intervention investigates the effect of an SMS-based health education program on vaccine intent in African American and Latino/Hispanic individuals. Recruited in-person and digitally throughout Michigan, 1327 participants were randomized into two arms, and then stratified into four audience segment groups based on vaccine readiness. The primary aim of the study is to increase uptake of the COVID-19 vaccine following receipt of the tailored text messages. Participants were evaluated pre- and post-intervention for intent to vaccinate, perceptions of barriers to vaccination, attitudes towards the vaccine, and knowledge of common vaccine misinformation.
Discussion
This study will inform future literature in addressing vaccine hesitancy for racial and ethnic populations, the use of motivational interviewing-based interventions, and digital health interventions in general.
{"title":"Increasing COVID-19 vaccine uptake through motivational interviewing-informed tailored digital intervention: Study protocol","authors":"C.P. Ku , Alex Christian , Emerson Delacroix , Kirsten Trzeciak , Ken Resnicow , Sarah Bailey , Barbara Israel , Felix Valbuena , Susie Williamson","doi":"10.1016/j.cct.2026.108221","DOIUrl":"10.1016/j.cct.2026.108221","url":null,"abstract":"<div><h3>Background</h3><div>Marginalized communities have been disproportionately impacted by COVID-19. In Michigan as of 2024, while 59% of Hispanic people, 46% of African American people, and 56% of White people received at least one dose of vaccine, only 8% of African American and 8% of Hispanic residents report being <em>up-to-date,</em> per CDC definition, compared to 13% of White residents. The goals of the project were to increase vaccine uptake through the implementation and evaluation of a tailored behavioral intervention.</div></div><div><h3>Methods</h3><div>This group-tailored digital intervention investigates the effect of an SMS-based health education program on vaccine intent in African American and Latino/Hispanic individuals. Recruited in-person and digitally throughout Michigan, 1327 participants were randomized into two arms, and then stratified into four audience segment groups based on vaccine readiness. The primary aim of the study is to increase uptake of the COVID-19 vaccine following receipt of the tailored text messages. Participants were evaluated pre- and post-intervention for intent to vaccinate, perceptions of barriers to vaccination, attitudes towards the vaccine, and knowledge of common vaccine misinformation.</div></div><div><h3>Discussion</h3><div>This study will inform future literature in addressing vaccine hesitancy for racial and ethnic populations, the use of motivational interviewing-based interventions, and digital health interventions in general.</div></div>","PeriodicalId":10636,"journal":{"name":"Contemporary clinical trials","volume":"162 ","pages":"Article 108221"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-17DOI: 10.1016/j.cct.2026.108226
Irene Pericot-Valverde , Moonseong Heo , Kaileigh A. Byrne , Alison Karasz , Angelica Perez , Snehal Lopes , Megan Groome , Sarah Voss , Ashley King , Katy Barnick , Alain H. Litwin
Medications for opioid use disorder (MOUD) are effective in reducing opioid use, but retention to buprenorphine remains suboptimal among OUD patients. Integration of computer-based cognitive behavioral therapy (CBT4CBT) and utilization of recovery coaches (RCs), called RC + CBT4CBT-Buprenorphine, into OUD care could improve drug use and retention in care among patients taking buprenorphine. The OVERCOME II (OUD Intervention Recovery Coach CBT and OUD Medications II) study is a three-arm 1:1:1 randomized clinical trial designed to test the remotely delivered RC + CBT4CBT-Buprenorphineintervention as an adjunct to buprenorphine treatment for patients with OUD, and to compare it with both CBT4CBT-Buprenorphine alone and the treatment as usual (TAU). Patients (n = 90) who have newly initiated buprenorphine in the past 90 days are planned to be recruited. Comprehensive measures on demographics, various conditions/constructs, and outcomes will be collected from medical charts and survey instruments. Additionally, neurophysiological outcomes and neurocognitive inhibitory controls will be measured using the NEXUS-10-MKII physiological system with BioTrace+ software and computerized Drug Go/NoGo Task, respectively. Qualitative analysis of interviews with N = 2 RCs and N = 15 participants will also be conducted. The study will be the first to examine the effectiveness of the remotely delivered RC + CBT4CBT-Buprenorphine intervention on drug use (during the first 8 weeks and follow-up) and retention in care, as well as on various neurophysiological and cognitive performances in comparison to CBT4CBT-Buprenorphine alone and TAU.
Clinical Trial Registration: This study was registered at ClinicalTrials.gov (NCT06102200, www.clinicaltrials.gov/) on August 31, 2023, with a title, An Integrated Intervention Involving Recovery Coaching and Cognitive Behavioral Therapy for Opioid Use Disorder (OVERCOME 2).
{"title":"Rationale and design of a three-arm randomized clinical trial to improve drug use and retention in care of people with opioid use disorder on buprenorphine: OVERCOME II study","authors":"Irene Pericot-Valverde , Moonseong Heo , Kaileigh A. Byrne , Alison Karasz , Angelica Perez , Snehal Lopes , Megan Groome , Sarah Voss , Ashley King , Katy Barnick , Alain H. Litwin","doi":"10.1016/j.cct.2026.108226","DOIUrl":"10.1016/j.cct.2026.108226","url":null,"abstract":"<div><div>Medications for opioid use disorder (MOUD) are effective in reducing opioid use, but retention to buprenorphine remains suboptimal among OUD patients. Integration of computer-based cognitive behavioral therapy (CBT4CBT) and utilization of recovery coaches (RCs), called RC + CBT4CBT-Buprenorphine, into OUD care could improve drug use and retention in care among patients taking buprenorphine. The OVERCOME II (<u><strong>O</strong></u>UD Inter<u><strong>ve</strong></u>ntion <u><strong>R</strong></u>ecovery <u><strong>C</strong></u>oach CBT and <u><strong>O</strong></u>UD <u><strong>Me</strong></u>dications II) study is a three-arm 1:1:1 randomized clinical trial designed to test the remotely delivered RC + CBT4CBT-Buprenorphineintervention as an adjunct to buprenorphine treatment for patients with OUD, and to compare it with both CBT4CBT-Buprenorphine alone and the treatment as usual (TAU). Patients (<em>n</em> = 90) who have newly initiated buprenorphine in the past 90 days are planned to be recruited. Comprehensive measures on demographics, various conditions/constructs, and outcomes will be collected from medical charts and survey instruments. Additionally, neurophysiological outcomes and neurocognitive inhibitory controls will be measured using the NEXUS-10-MKII physiological system with BioTrace+ software and computerized Drug Go/NoGo Task, respectively. Qualitative analysis of interviews with <em>N</em> = 2 RCs and <em>N</em> = 15 participants will also be conducted. The study will be the first to examine the effectiveness of the remotely delivered RC + CBT4CBT-Buprenorphine intervention on drug use (during the first 8 weeks and follow-up) and retention in care, as well as on various neurophysiological and cognitive performances in comparison to CBT4CBT-Buprenorphine alone and TAU.</div><div><strong>Clinical Trial Registration:</strong> This study was registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (NCT06102200, <span><span>www.clinicaltrials.gov/</span><svg><path></path></svg></span>) on August 31, 2023, with a title, An Integrated Intervention Involving Recovery Coaching and Cognitive Behavioral Therapy for Opioid Use Disorder (OVERCOME 2).</div></div>","PeriodicalId":10636,"journal":{"name":"Contemporary clinical trials","volume":"162 ","pages":"Article 108226"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-05DOI: 10.1016/j.cct.2026.108253
Mathilde S. Madsen , Marianne Melau , Naja K. Andersen , Caroline Friis Nielsen , Natascha Larsen , Thomas Lind Andersen , Merete Nordentoft , Jens Richardt M. Jepsen , Anne A.E. Thorup , Pia Jeppesen , Birgitte Fagerlund , Martin Køster Rimvall , Patrick McGorry , Swaran Singh , Ditte Lammers Vernal , Lene Halling Hastrup , Lis Raabæk Olsen , Jacob Rydkjær , Christoph U. Correll , Robin Christensen , Anne Katrine Pagsberg
Background
The prognosis for early onset psychosis (EOP) is poor for a broad range of outcomes. Early intervention services (EIS) have proven beneficial for adult-onset first-episode psychosis, but no randomized trials have investigated EIS in samples of patients aged <18 years. We will examine benefits and harms of a new integrated intervention OPUS YOUNG for EOP. The primary objective is to compare the effect of the OPUS YOUNG intervention versus treatment as usual (TAU) on change in social functioning at end-of-treatment after two years.
Methods
This investigator-initiated, single-center, pragmatic randomized clinical trial with blinded outcome assessment takes place in child- and adolescent mental health services in Copenhagen, Denmark. We randomize 290 participants aged 12 to 17 years with first-onset psychosis in a 1:1 ratio to a two-year intervention with OPUS YOUNG versus TAU. The OPUS YOUNG manual builds on the Danish evidence-based intervention for young adults (OPUS) adjusted to meet the specific needs of youths. The primary outcome is social functioning (Personal and Social Performance Scale [PSP] total score). Key secondary outcomes include measures of psychotic, negative, and disorganized symptom dimensions, client satisfaction, and health-related quality of life. Analyses will follow the intention-to-treat principle and use mixed-effects repeated measures models.
Discussion
In a rigorous research design, we address the urgent need for evidence-based interventions integrating psychosocial and pharmacological treatments in an age-appropriate manualized program for EOP. The primary trial limitations are the risk of attrition during follow-up, and the inherent inability to mask for allocation in trials with psychosocial interventions.
Trial registration
ClinicalTrials.gov: NCT04916626, registered June 2021. Protocol and modifications is presented here:
{"title":"Early intervention versus treatment as usual for adolescents with first-episode psychosis: Protocol for the randomized OPUS YOUNG trial","authors":"Mathilde S. Madsen , Marianne Melau , Naja K. Andersen , Caroline Friis Nielsen , Natascha Larsen , Thomas Lind Andersen , Merete Nordentoft , Jens Richardt M. Jepsen , Anne A.E. Thorup , Pia Jeppesen , Birgitte Fagerlund , Martin Køster Rimvall , Patrick McGorry , Swaran Singh , Ditte Lammers Vernal , Lene Halling Hastrup , Lis Raabæk Olsen , Jacob Rydkjær , Christoph U. Correll , Robin Christensen , Anne Katrine Pagsberg","doi":"10.1016/j.cct.2026.108253","DOIUrl":"10.1016/j.cct.2026.108253","url":null,"abstract":"<div><h3>Background</h3><div>The prognosis for early onset psychosis (EOP) is poor for a broad range of outcomes. Early intervention services (EIS) have proven beneficial for adult-onset first-episode psychosis, but no randomized trials have investigated EIS in samples of patients aged <18 years. We will examine benefits and harms of a new integrated intervention OPUS YOUNG for EOP. The primary objective is to compare the effect of the OPUS YOUNG intervention versus treatment as usual (TAU) on change in social functioning at end-of-treatment after two years.</div></div><div><h3>Methods</h3><div>This investigator-initiated, single-center, pragmatic randomized clinical trial with blinded outcome assessment takes place in child- and adolescent mental health services in Copenhagen, Denmark. We randomize 290 participants aged 12 to 17 years with first-onset psychosis in a 1:1 ratio to a two-year intervention with OPUS YOUNG versus TAU. The OPUS YOUNG manual builds on the Danish evidence-based intervention for young adults (OPUS) adjusted to meet the specific needs of youths. The primary outcome is social functioning (Personal and Social Performance Scale [PSP] total score). Key secondary outcomes include measures of psychotic, negative, and disorganized symptom dimensions, client satisfaction, and health-related quality of life. Analyses will follow the intention-to-treat principle and use mixed-effects repeated measures models.</div></div><div><h3>Discussion</h3><div>In a rigorous research design, we address the urgent need for evidence-based interventions integrating psychosocial and pharmacological treatments in an age-appropriate manualized program for EOP. The primary trial limitations are the risk of attrition during follow-up, and the inherent inability to mask for allocation in trials with psychosocial interventions.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>: <span><span>NCT04916626</span><svg><path></path></svg></span>, registered June 2021. Protocol and modifications is presented here:</div><div><span><span>https://classic.clinicaltrials.gov/ct2/show/NCT04916626</span><svg><path></path></svg></span></div></div>","PeriodicalId":10636,"journal":{"name":"Contemporary clinical trials","volume":"162 ","pages":"Article 108253"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-28DOI: 10.1016/j.cct.2026.108243
Werner Vach , Franziska Saxer
Background
When using a patient reported outcome as primary endpoint in a randomized contolled trial (RCT), responder analyses are widely used to describe the relevance of an observed effect attributable to the intervention of interest. The choice of thresholds in responder analyses is often based on minimal important change (MIC) values.
Methods
As an alternative to simply computing MIC values, we suggest determining a translation function allowing to translate change scores values into the probability of experiencing an improvement. The application of such a translation function to the change scores observed in an RCT allows estimating arm-specific probabilities of experiencing an improvement. These values are conceptually similar to responder frequencies. The approach is illustrated using a pair of synthetic studies, both constructed mimicking existing studies. A simulation study investigates the gain in efficiency from avoiding the dichotomization.
Results
The illustrative application of the methodology demonstrates that the approach is feasible and allows drawing conclusions in a similar way as in a responder analysis, but with greater precision. The simulation study confirms that this gain in efficiency holds more generally. Considering all response levels of the anchor variable may allow gaining more nuanced insights.
Conclusions
Estimating the probability of experiencing an improvement provides an alternative to responder analyses. This approach makes more efficient use of information comprised in the data from anchor-based MIC studies than the translation into MIC values to inform the choice of thresholds in a responder analysis.
{"title":"Estimating the probability of experiencing an improvement in randomized controlled trials based on anchor-based MIC studies – An alternative to responder analyses","authors":"Werner Vach , Franziska Saxer","doi":"10.1016/j.cct.2026.108243","DOIUrl":"10.1016/j.cct.2026.108243","url":null,"abstract":"<div><h3>Background</h3><div>When using a patient reported outcome as primary endpoint in a randomized contolled trial (RCT), responder analyses are widely used to describe the relevance of an observed effect attributable to the intervention of interest. The choice of thresholds in responder analyses is often based on minimal important change (MIC) values.</div></div><div><h3>Methods</h3><div>As an alternative to simply computing MIC values, we suggest determining a translation function allowing to translate change scores values into the probability of experiencing an improvement. The application of such a translation function to the change scores observed in an RCT allows estimating arm-specific probabilities of experiencing an improvement. These values are conceptually similar to responder frequencies. The approach is illustrated using a pair of synthetic studies, both constructed mimicking existing studies. A simulation study investigates the gain in efficiency from avoiding the dichotomization.</div></div><div><h3>Results</h3><div>The illustrative application of the methodology demonstrates that the approach is feasible and allows drawing conclusions in a similar way as in a responder analysis, but with greater precision. The simulation study confirms that this gain in efficiency holds more generally. Considering all response levels of the anchor variable may allow gaining more nuanced insights.</div></div><div><h3>Conclusions</h3><div>Estimating the probability of experiencing an improvement provides an alternative to responder analyses. This approach makes more efficient use of information comprised in the data from anchor-based MIC studies than the translation into MIC values to inform the choice of thresholds in a responder analysis.</div></div>","PeriodicalId":10636,"journal":{"name":"Contemporary clinical trials","volume":"162 ","pages":"Article 108243"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146092331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-29DOI: 10.1016/j.cct.2026.108246
Madeline Price , Gowri Sunder , Marylene Cloitre , Debra Kaysen , Martha Shumway , James W. Dilley , Nadra E. Lisha , Belin Marko , William Hua , Tiffany Artime , Ell Hundertmark , Emily Huang , Antonia Clifford , Annesa Flentje
Background
LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual +) individuals face higher rates of posttraumatic stress disorder (PTSD) due to increased trauma exposure. Further, they may experience factors that complicate treatment, like exposure to minority stress and increased substance use. No prior large-scale clinical trial has compared the effectiveness of PTSD treatments among LGBTQIA+ populations.
Study objectives
We are conducting a comparative effectiveness study that will compare two evidence-based psychotherapeutic interventions to reduce PTSD and depression symptoms and improve quality of life in LGBTQIA+ populations. Treatment dropout and satisfaction will be compared between the interventions. Minority stress and substance use will be examined as moderators for treatment effectiveness. We will also examine heterogeneity of treatment effects by gender subgroups, participant residence (urban versus suburban or rural), and race and ethnicity.
Methods
Participants will be recruited from community mental health settings, from the community, and through organizations throughout California. Eligibility will be based on PTSD symptom severity as determined by PTSD Checklist for DSM-5 (PCL-5) scores ≥33 during an initial phone screening. Each participant will be randomized to receive either Cognitive Processing Therapy (CPT) or STAIR Narrative Therapy (SNT). Study participants will complete survey assessments at baseline, 3 months, 6 months, and 12 months.
Discussion
This study will fill critical research gaps to inform effective PTSD treatments for LGBTQIA+ communities.
{"title":"A protocol for a randomized comparative effectiveness trial for treating PTSD symptoms for LGBTQIA+ people","authors":"Madeline Price , Gowri Sunder , Marylene Cloitre , Debra Kaysen , Martha Shumway , James W. Dilley , Nadra E. Lisha , Belin Marko , William Hua , Tiffany Artime , Ell Hundertmark , Emily Huang , Antonia Clifford , Annesa Flentje","doi":"10.1016/j.cct.2026.108246","DOIUrl":"10.1016/j.cct.2026.108246","url":null,"abstract":"<div><h3>Background</h3><div>LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual +) individuals face higher rates of posttraumatic stress disorder (PTSD) due to increased trauma exposure. Further, they may experience factors that complicate treatment, like exposure to minority stress and increased substance use. No prior large-scale clinical trial has compared the effectiveness of PTSD treatments among LGBTQIA+ populations.</div></div><div><h3>Study objectives</h3><div>We are conducting a comparative effectiveness study that will compare two evidence-based psychotherapeutic interventions to reduce PTSD and depression symptoms and improve quality of life in LGBTQIA+ populations. Treatment dropout and satisfaction will be compared between the interventions. Minority stress and substance use will be examined as moderators for treatment effectiveness. We will also examine heterogeneity of treatment effects by gender subgroups, participant residence (urban versus suburban or rural), and race and ethnicity.</div></div><div><h3>Methods</h3><div>Participants will be recruited from community mental health settings, from the community, and through organizations throughout California. Eligibility will be based on PTSD symptom severity as determined by PTSD Checklist for DSM-5 (PCL-5) scores ≥33 during an initial phone screening. Each participant will be randomized to receive either Cognitive Processing Therapy (CPT) or STAIR Narrative Therapy (SNT). Study participants will complete survey assessments at baseline, 3 months, 6 months, and 12 months.</div></div><div><h3>Discussion</h3><div>This study will fill critical research gaps to inform effective PTSD treatments for LGBTQIA+ communities.</div></div>","PeriodicalId":10636,"journal":{"name":"Contemporary clinical trials","volume":"162 ","pages":"Article 108246"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-19DOI: 10.1016/j.cct.2026.108227
Noe C. Crespo , John Elder , Eyal Oren , Elva Arredondo , Chii-Dean Joey Lin , Job Godino , Hala Madanat , Griselda Cervantes , Amanda Patron , Kiria Fraga , Bianca Vargas-Tequida , Christian B. Ramers
Background
COVID-19 has disproportionately affected minority groups, including Latinos. Since the development of COVID-19 vaccines, effective implementation faced challenges due to multiple factors, necessitating multi-level and multi-sector approaches. This study describes the Vaccine Promotion Program (VPP), a multi-level intervention to increase COVID-19 vaccine uptake among Latinos in clinical and community settings.
Methods
VPP is a double-blind, pragmatic, 12-month cluster-randomized trial in collaboration with a large Federally Qualified Health Center (FQHC) in San Diego, CA. Ten clinics will be randomized to a Multilevel Intervention involving activities at the interpersonal, clinic, and community levels (VPP) or Standard Clinical Practice (SCP) (n = 5 clinics, respectively). Patients in VPP clinics will receive tailored clinic-originated messages about COVID-19 vaccination and motivational interviews (MI) (15–30-min telephone/telehealth encounters) from Health Educators (HE) to encourage COVID-19 vaccination. HEs will send emails and/or text message-based information to encourage vaccination. The community-level intervention involves targeted and tailored activities to promote COVID-19 vaccine uptake in neighborhoods surrounding the five VPP clinics. A cohort of 200 patients will be enrolled to participate in comprehensive surveys and follow-up for 24 months to assess longer-term outcomes. The primary outcome (COVID-19 aggregated vaccination rates) will be compared at baseline, 6, and 12 months between VPP and SCP clinics and neighborhoods, respectively.
Discussion
VPP directly addresses the most prominent COVID-19 vaccination barriers, including health literacy, community trust, and vaccine access, through a multi-level approach in collaboration with an FQHC. This approach has the potential to be an effective and scalable public health approach to vaccination among underserved communities.
{"title":"A multilevel clinic- and community-based intervention to increase COVID-19 vaccination among Latinos in San Diego County: Protocol description of the vaccine promotion program","authors":"Noe C. Crespo , John Elder , Eyal Oren , Elva Arredondo , Chii-Dean Joey Lin , Job Godino , Hala Madanat , Griselda Cervantes , Amanda Patron , Kiria Fraga , Bianca Vargas-Tequida , Christian B. Ramers","doi":"10.1016/j.cct.2026.108227","DOIUrl":"10.1016/j.cct.2026.108227","url":null,"abstract":"<div><h3>Background</h3><div>COVID-19 has disproportionately affected minority groups, including Latinos. Since the development of COVID-19 vaccines, effective implementation faced challenges due to multiple factors, necessitating multi-level and multi-sector approaches. This study describes the Vaccine Promotion Program (VPP), a multi-level intervention to increase COVID-19 vaccine uptake among Latinos in clinical and community settings.</div></div><div><h3>Methods</h3><div>VPP is a double-blind, pragmatic, 12-month cluster-randomized trial in collaboration with a large Federally Qualified Health Center (FQHC) in San Diego, CA. Ten clinics will be randomized to a Multilevel Intervention involving activities at the interpersonal, clinic, and community levels (VPP) or Standard Clinical Practice (SCP) (<em>n</em> = 5 clinics, respectively). Patients in VPP clinics will receive tailored clinic-originated messages about COVID-19 vaccination and motivational interviews (MI) (15–30-min telephone/telehealth encounters) from Health Educators (HE) to encourage COVID-19 vaccination. HEs will send emails and/or text message-based information to encourage vaccination. The community-level intervention involves targeted and tailored activities to promote COVID-19 vaccine uptake in neighborhoods surrounding the five VPP clinics. A cohort of 200 patients will be enrolled to participate in comprehensive surveys and follow-up for 24 months to assess longer-term outcomes. The primary outcome (COVID-19 aggregated vaccination rates) will be compared at baseline, 6, and 12 months between VPP and SCP clinics and neighborhoods, respectively.</div></div><div><h3>Discussion</h3><div>VPP directly addresses the most prominent COVID-19 vaccination barriers, including health literacy, community trust, and vaccine access, through a multi-level approach in collaboration with an FQHC. This approach has the potential to be an effective and scalable public health approach to vaccination among underserved communities.</div></div>","PeriodicalId":10636,"journal":{"name":"Contemporary clinical trials","volume":"162 ","pages":"Article 108227"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}