Pediatrics

Basket and umbrella trials can increase pediatric trial efficiency for biomarker-defined subgroups

This systematic review included 28 pediatric-focused studies from 1867 records characterizing basket and umbrella trial designs. Authors found basket trials were more prevalent, especially in early-phase oncology and rare-disease research. These designs can improve efficiency and enable precision targeting, but success requires robust statistical planning. Careful use of Bayesian methods and attention to regulatory guidance were highlighted as necessary safeguards. 1

Umbrella review: condition- and strain-specific benefits of probiotics, prebiotics, and synbiotics

This umbrella review synthesized 128 systematic reviews and meta-analyses of biotics published since 2023. Evidence supports reduced necrotizing enterocolitis in infants and some metabolic and GI benefits in adults. Most biotics were well tolerated, but authors note a safety signal for sepsis in vulnerable pediatric patients. Heterogeneity across studies and variable strain effects limit broad generalization of benefits. 2

Digital bedside guideline platform associated with shorter LOS and lower NRM after pediatric allogeneic HCT

In a single-center three-era cohort, sustained platform use was associated with 14% shorter LOS (ratio 0.858; p=0.018). Adjusted mean LOS fell from 53.32 to 45.74 days with sustained adoption. Adjusted analyses showed lower nonrelapse mortality (SHR 0.212; 95% CI 0.054–0.826; p=0.025) in the sustained-use era. No increase in ICU admission or 30-day readmission was observed, though follow-up for late outcomes was limited. 3