A national perioperative platform trial to improve outcomes for surgical patients (PROTECT)

ISRCTN ISRCTN14639555
DOI https://doi.org/10.1186/ISRCTN14639555
ClinicalTrials.gov (NCT) Nil known
Clinical Trials Information System (CTIS) Nil known
Integrated Research Application System (IRAS) 353122
Protocol serial number Nil known
Sponsor Queen Mary University of London
Funders Barts Charity, British Journal of Anaesthesia, Academy of Medical Sciences
Submission date
20/06/2025
Registration date
23/06/2025
Last edited
23/06/2025
Recruitment status
Recruiting
Overall study status
Ongoing
Condition category
Surgery
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Clinical implementation of new treatments requires evidence from clinical trials. Traditional clinical trials compare two groups: a treatment group and a control group. However, traditional trials are time-consuming and expensive, often taking a long time to set-up, open new centres and start enrolling patients. This delays implementation of new treatments. Platform trials offer a new approach that was used very successfully during the pandemic. Instead of comparing one treatment group to one control group, platform trials compare multiple treatment groups to one control group. Once established, platforms continue to run, with new treatments added as they become available. This reduces the overall number of patients required and reduces the time and cost of setting up a new trial, which makes platform trials a very efficient way to test new treatments. Our aim is to establish a national platform trial for surgical patients is urgently needed.

Who can participate?
Patients aged 18 years and over being treated in an NHS surgical care pathway.

What does the study involve?
This is a trial designed to test multiple research questions for patients undergoing surgery, or within a surgical care pathway. Patient eligibility will be evaluated separately for each research question and they will be offered the opportunity to take part in any or all of the studies for which they are eligible.

For participants who enrol in the Protect platform only, a common outcome dataset will be collected at 30 days and 90 days after surgery about their health and well-being. In addition, longer-term outcomes may be collected using national NHS databases including Hospital Episode Statistics or the equivalent databases in Wales, Scotland and Northern Ireland, and Civil Registration Data.

What are the possible benefits and risks of participating?
Participants may not benefit directly from taking part in this study. By taking part in studies looking at new ways to improve the care they will receive and by allowing the research team to collect information about their healthcare, we hope to improve the health outcomes for surgical patients in the future.

Where is the study run from?
Surgical services of NHS hospitals (UK)

When is the study starting and how long is it expected to run for?
January 2025 to December 2034

Who is funding the study?
1. Barts Charity (G-002514)
2. Academy of Medical Science (SGL029\1104)
3. British Journal of Anaesthesia (WKR0-2023-0016)

Who is the main contact?
1. Priyanthi Dias (p.dias@qmul.ac.uk)
2. Salma Begum (salma2.begum@qmul.ac.uk)

Contact information

Dr Priyanthi Dias
Public

ACCU Research Offices
4th Floor, Office 14
Royal London Hospital
Whitechapel
London
E1 1FR
United Kingdom

ORCiD logoORCID ID 0000-0003-1740-6165
Phone +44 20 3594 0349
Email p.dias@qmul.ac.uk
Dr Tom Abbott
Scientific, Principal investigator

ACCU Research Offices
4th Floor, Office 14
Royal London Hospital
Whitechapel
London
E1 1FR
United Kingdom

ORCiD logoORCID ID 0000-0002-8664-3001
Phone +44 20 3594 0349
Email t.abbott@qmul.ac.uk

Study information

Primary study designInterventional
Study designThis is a multi-centre multi-factorial platform trial designed to test multiple comparisons (research questions) for patients undergoing surgery, or within a surgical care pathway. Patient eligibility will be evaluated for the platform (master protocol) and for each comparison (protocol appendix). Patients enrolled in the PROTECT platform will be offered the opportunity to take part in any and/or all of the comparisons for which they are eligible. Patients can be enrolled in the platform (master protocol) only or the platform (master protocol) plus one or more comparison(s). Comparisons may be contemporaneous or distributed throughout the surgical care pathway. As new comparisons are added to the platform, they will be assigned a comparison-specific acronym suffix (e.g. PROTECT-AEGIS, etc.), and the comparison-specific trial methodology and delivery will be described in separate appendices to this master protocol document. Each comparison will be added as an individual submission to the relevant regulatory authorities. Amendments made to the master protocol will apply to all appendices. Amendments to an appendix describing an individual comparison(s) will only be relevant to that appendix. The PROTECT master protocol is the over-arching protocol which describes the common trial design, delivery and data sets, as well as trial governance procedures common to all comparisons within the platform. Where additional procedures are required, specific to a comparison, for example the collection of additional safety data, these will be described in the appendix for that comparison. The individual appendices are not co-dependent and each will have a separate start and end date. Appendices to the PROTECT master protocol will be added and/or removed throughout the course of the programme. Analyses will be conducted on locked comparison specific datasets and published without compromising the integrity of ongoing platform comparisons. Each individual comparison will have a lead investigator listed in the comparison appendix. Participants enrolled into PROTECT will fall into one or more of the below study categories depending on the eligibility criteria and the journey of their care pathway: • PROTECT platform • Non-interventional (non-randomised) studies • Interventional studies that do not involve Investigational Medicinal Products (IMPs) • Interventional studies that involve an IMP
Secondary study designPlatform trial
Study type Participant information sheet
Scientific titleA national perioperative platform trial to improve outcomes for surgical patients (PROTECT)
Study acronymPROTECT
Study objectivesTo establish a research and governance infrastructure for the efficient delivery of a suite of surgical and/or perioperative care comparisons to improve outcomes for patients undergoing surgery.
Ethics approval(s)

Approved 03/02/2025, London - South East Research Ethics Committee (2 Redman Place, London, E20 1JQ, United Kingdom; +44 207 104 8222; londonsoutheast.rec@hra.nhs.uk), ref: 25/LO/0043

Health condition(s) or problem(s) studiedAll adult patients (≥18 years) being treated within a surgical care pathway at the recruitment sites will be eligible for the trial.
InterventionA common outcome dataset will be collected for all patients at 30 days and 90 days after surgery. In addition, longer-term outcomes may be collected using routinely collected data (for example Hospital Episode Statistics (HES) and Civil Registration data) up until the last follow up time-point for the participant according to the nature of the groups in which they are enrolled in. Where applicable, primary and secondary outcomes will be described in full in the relevant appendix. Additionally, for CTIMPs, depending on the risk and status of the investigations, part of the objectives will be to collect safety endpoints.
Intervention typeOther
Primary outcome measure(s)

Measured using patient records:
1. Complications within 30 days after surgery
2. Days alive and at home at 30 and 90 days after surgery
3. Mortality at 30 and 90 days and one year after surgery
4. Health-related quality of Life (EQ-5D-5L) at 30 and 90 days after surgery
5. Duration of primary hospital admission up to 90 days after surgery
6. Re-admission to hospital within 90 days of surgery

Key secondary outcome measure(s)

There are no secondary outcome measures

Completion date01/01/2035

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
Upper age limit100 Years
SexAll
Target sample size at registration932
Key inclusion criteriaAll adult patients (≥18 years) being treated within a surgical care pathway at the recruitment sites will be eligible for the trial.
Key exclusion criteriaInability or refusal to provide informed consent.
Date of first enrolment01/01/2025
Date of final enrolment01/01/2035

Locations

Countries of recruitment

  • United Kingdom
  • England
  • Scotland
  • Wales

Study participating centres

Barts Health NHS Trust
The Royal London Hospital
80 Newark Street
London
E1 2ES
United Kingdom
Plymouth Hospitals NHS Trust
Derriford Hospital
Derriford Road
Crownhill
Plymouth
PL6 8DH
United Kingdom
The Royal Marsden Hospital
Fulham Road
London
SW3 6JJ
United Kingdom
University Hospitals Birmingham NHS Foundation Trust
Queen Elizabeth Hospital
Mindelsohn Way
Edgbaston
Birmingham
B15 2GW
United Kingdom
University Hospital Southampton NHS Foundation Trust
Southampton General Hospital
Tremona Road
Southampton
SO16 6YD
United Kingdom
Croydon Health Services NHS Trust
Croydon University Hospital
530 London Road
Thornton Heath
CR7 7YE
United Kingdom
The Newcastle upon Tyne Hospitals NHS Foundation Trust
Freeman Hospital
Freeman Road
High Heaton
Newcastle upon Tyne
NE7 7DN
United Kingdom
Leeds Teaching Hospitals NHS Trust
St. James's University Hospital
Beckett Street
Leeds
LS9 7TF
United Kingdom
Barking, Havering and Redbridge University Hospitals NHS Trust
Queens Hospital
Rom Valley Way
Romford
RM7 0AG
United Kingdom
NHS National Waiting Times Centre Board
Agamemnon Street
Clydebank
G81 4DY
United Kingdom
NHS Grampian
Summerfield House
2 Eday Road
Aberdeen
AB15 6RE
United Kingdom
Surrey and Sussex Healthcare NHS Trust
Trust Headquarters
East Surrey Hospital
Canada Avenue
Redhill
RH1 5RH
United Kingdom
Manchester University NHS Foundation Trust
Cobbett House
Oxford Road
Manchester
M13 9WL
United Kingdom
South Tyneside and Sunderland NHS Foundation Trust
Sunderland Royal Hospital
Kayll Road
Sunderland
SR4 7TP
United Kingdom
University Hospital of Wales
Heath Park
Cardiff
CF14 4XW
United Kingdom

Results and Publications

Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryOther
IPD sharing planAvailable on request. Data sharing statement to be made available at a later date.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Participant information sheet Participant information sheet 11/11/2025 11/11/2025 No Yes
Study website Study website 11/11/2025 11/11/2025 No Yes

Editorial Notes

20/06/2025: Trial's existence confirmed by Barts Charity