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©Author(s) (or their employer(s)) 2026.
World J Clin Pediatr. Mar 9, 2026; 15(1): 113925
Published online Mar 9, 2026. doi: 10.5409/wjcp.v15.i1.113925
Table 5 Novel strategies to improve clinical trials in pediatric constipation
Suggestion
Description
Adaptive trial designUse adoptive Bayesian or response-adaptive randomization designs, which allow modification of the study as data accumulate. It may help to find subgroups that respond to the intervention
Biomarker or mechanism-based approachInstead of using the symptom-based outcome measures, it is possible to use biomarkers such as improved colonic transit and alteration of anorectal physiology after therapy as endpoints
Emphasize more on patient-centered outcomesRather than relying on symptom-based endpoints, using other measures, including improvement of quality of life, improvement of school attendance, can be used to assess the efficacy
Network meta-analysis to assess relative efficacyThis method helps to combine direct and indirect evidence to estimate the relative efficacy for each pair of interventions


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