Clinical Trial Protocol Template (SPIRIT 2025)
Randomised trial protocol following the 34 SPIRIT 2025 items: open science, PPI, interventions, harms, timeline, monitoring
사용법: Use before enrolment to write the protocol submitted to ethics and the registry. Fill the outcomes, harms and sample size sections first because they drive the rest, then the open science and dissemination plans. The main pitfall is a data sharing plan that the consent form does not permit.
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Clinical Trial Protocol: [Full trial title]
Protocol template for a randomised clinical trial. The sections follow the topics and order of the SPIRIT 2025 Statement (administrative information, open science, introduction, methods, ethics), which replaced SPIRIT 2013 and has 34 checklist items plus a participant timeline figure. Topics are written in original words for this collection; use the template with the official SPIRIT 2025 checklist from consort-spirit.org and with your regulator's and sponsor's requirements (for example ICH E6 Good Clinical Practice). This is a document format, not clinical, regulatory or statistical advice. Replace every
[bracketed]value and every row marked Example.
Document control
| Field | Value |
|---|---|
| Document ID | [PROT-ACRONYM-001] |
| Trial acronym | [ACRONYM] |
| Protocol version | [1.0] |
| Version date | YYYY-MM-DD |
| Status | [Draft / In review / Approved / Superseded] |
| Owner | [@chief-investigator] |
| Approvers | [@sponsor-representative], [@trial-statistician] |
| Ethics reference | [REC / IRB reference] |
| Regulatory reference | [Clinical trial authorisation number or "not applicable"] |
| Reporting guideline | SPIRIT 2025 [plus extensions used] |
| Last updated | YYYY-MM-DD |
| Classification | [Confidential] |
Approvals
| Role | Name | Signature reference | Date |
|---|---|---|---|
| Chief investigator | [@name] | [Reference] | YYYY-MM-DD |
| Sponsor representative | [@name] | [Reference] | YYYY-MM-DD |
| Trial statistician | [@name] | [Reference] | YYYY-MM-DD |
| Principal investigator (each site) | [@name] | [Reference] | YYYY-MM-DD |
Revision history
| Version | Date | Author | Change summary | Amendment type |
|---|---|---|---|---|
| 0.1 | YYYY-MM-DD | [@name] | First draft for sponsor review | Not applicable |
| 1.0 | YYYY-MM-DD | [@name] | Approved for submission to ethics committee | Not applicable |
| 2.0 | YYYY-MM-DD | [@name] | Example: Added two sites; extended recruitment by 6 months | Substantial |
Contents
1. Administrative information
This section identifies the trial, the protocol version and the people and committees responsible for it.
1.1 Title and structured summary (items 1a, 1b)
Title: [Descriptive title stating the design, population and interventions, identifying the document as a protocol, for example "A multicentre, double-blind, placebo-controlled randomised trial of [intervention] for [condition] in adults: study protocol"].
Structured summary: A short summary of the trial design and methods that includes the items of the WHO Trial Registration Data Set.
| Item | Value |
|---|---|
| Primary registry and number | [Registry, number] |
| Sponsor | [Organisation] |
| Health condition | [Condition] |
| Interventions | [Intervention and comparator] |
| Key eligibility | [Main inclusion and exclusion criteria] |
| Study type and design | [Randomised, parallel, 1:1, double-blind] |
| Target sample size | [190] |
| Primary outcome | [Outcome and time point] |
| Date of first enrolment | YYYY-MM-DD (planned) |
1.2 Protocol version (item 2)
Version [1.0], dated [YYYY-MM-DD], identifier [PROT-ACRONYM-001]. See the revision history above.
1.3 Roles and responsibilities (items 3a to 3d)
| Role or committee | Members or organisation | Responsibilities |
|---|---|---|
| Protocol contributors | [Names, affiliations, roles] | [Who wrote which parts] |
| Sponsor | [Organisation, contact name, email] | [Overall responsibility, insurance] |
| Role of sponsor and funders | [Statement] | Example: No role in design, analysis or reporting; no right to veto publication |
| Coordinating centre | [Clinical trials unit] | [Day-to-day management] |
| Trial steering committee | [Independent chair and members] | [Oversight; decides on continuation] |
| Endpoint adjudication committee | [Members or "not applicable"] | [Blinded review of primary events] |
| Data management team | [Team] | [Database, coding, cleaning] |
| Data monitoring committee | [Members] | See section 7.1 |
2. Open science
These items make the trial and its materials findable and its funding and interests transparent.
2.1 Trial registration (item 4)
| Item | Value |
|---|---|
| Registry | [ClinicalTrials.gov / ISRCTN / EU CTIS / national registry] |
| Registration number and URL | [Number, link] |
| Date of registration | YYYY-MM-DD |
| If not yet registered | [Name of intended registry] |
2.2 Protocol and statistical analysis plan (item 5)
The protocol will be available at [journal / registry / repository link]. The statistical analysis plan (SAP) will be finalised before unblinding and published at [link] by [YYYY-MM-DD].
2.3 Data sharing (item 6)
| Material | Plan | Where | When | Access conditions |
|---|---|---|---|---|
| De-identified individual participant data | Example: Shared | [Repository] | 6 months after primary publication | Approved proposal and data use agreement |
| Data dictionary | [Shared / not shared] | [Repository] | [When] | [Conditions] |
| Statistical code | Example: Shared | [Code repository] | At publication | Open licence |
| Other materials (case report forms, intervention manual) | [Plan] | [Where] | [When] | [Conditions] |
2.4 Funding and conflicts of interest (items 7a, 7b)
| Item | Detail |
|---|---|
| Sources of funding | [Funder, grant number] |
| Other support | [Supply of drugs or devices] |
| Conflicts of interest | [Financial and other interests of principal investigators and steering committee members] |
2.5 Dissemination policy (item 8)
| Audience | Plan |
|---|---|
| Participants | Example: Plain-language summary mailed within 12 months of trial completion |
| Trial registry | [Results posted within the registry's required time frame] |
| Healthcare professionals | [Journal publication regardless of result; conference presentation] |
| Public and other groups | [Patient charity newsletter, press release] |
| Authorship | [Criteria, for example ICMJE; no professional writers] |
3. Introduction
The introduction explains why this trial is needed now.
3.1 Background and rationale (item 9a)
[Summarise the condition, current care and the evidence gap, including published and unpublished studies on the benefits and harms of each intervention. Cite the relevant systematic review or explain why none exists.]
3.2 Choice of comparator (item 9b)
[Explain why the comparator (placebo, usual care, active treatment) is appropriate and ethical.]
3.3 Objectives (item 10)
| ID | Objective | Hypothesis |
|---|---|---|
| OBJ-01 | Example: Determine whether [intervention] reduces [primary outcome] at 12 weeks compared with placebo | Superiority, minimal important difference 5 points |
| OBJ-02 | [Secondary benefit objective] | [Hypothesis] |
| OBJ-03 | Compare the frequency of [specified harms] between arms | Descriptive |
4. Methods: patient and public involvement, trial design, participants, interventions and outcomes
This section covers involvement, design, population, interventions, outcomes, timeline, sample size and recruitment.
4.1 Patient and public involvement (item 11)
| Stage | Who | Activity | Influence on the protocol |
|---|---|---|---|
| Design | Example: 6 people with [condition] in a lived-experience panel | Two workshops on outcomes and visit burden | Patient-reported primary outcome; visits reduced from 6 to 4 |
| Conduct | [Who] | [Review of participant information, steering committee membership] | [Influence] |
| Reporting | [Who] | [Co-writing the plain-language summary] | [Influence] |
4.2 Trial design (item 12)
[Type of trial (parallel, crossover, factorial, cluster), allocation ratio and framework (superiority, equivalence, non-inferiority, exploratory). For example: multicentre, randomised, double-blind, placebo-controlled, parallel-group superiority trial, 1:1 allocation.]
4.3 Trial setting (item 13)
[Settings (community clinics, academic hospitals) and locations (countries, number of sites). Give the list of sites in appendix E or say where it can be obtained.]
4.4 Eligibility criteria (items 14a, 14b)
Participants: inclusion criteria
- [Age 18 years or older]
- [Diagnosis of [condition] confirmed by [method]]
- [Severity above threshold]
- [Able and willing to give written informed consent]
Participants: exclusion criteria
- [Known hypersensitivity to the investigational product]
- [Pregnancy or breastfeeding]
- [Participation in another interventional trial within 30 days]
Sites and intervention providers (if applicable): [for example sites must see at least 20 eligible patients a year; therapists need two years' experience and completion of the trial training course].
4.5 Intervention and comparator (items 15a to 15d)
| Element | Intervention arm | Comparator arm |
|---|---|---|
| Description (15a) | [Product, dose, route, frequency, duration, who administers] | [Placebo or comparator details] |
| Additional materials (15a) | [Intervention manual, link] | [Link] |
| Discontinuation or modification (15b) | Example: Halve dose for grade 2 toxicity; stop for grade 3 or above or on participant request | [Same rules] |
| Adherence strategies and monitoring (15c) | [Pill counts at each visit, diary, reminder messages] | [Same] |
| Concomitant care permitted (15d) | [List] | [List] |
| Concomitant care prohibited (15d) | [List] | [List] |
4.6 Outcomes (item 16)
| ID | Outcome | Variable | Metric | Aggregation | Time point |
|---|---|---|---|---|---|
| OUT-P1 | Example: Symptom severity (primary) | [Validated scale score, 0-50] | Change from baseline | Mean | Week 12 |
| OUT-S1 | Response | Score reduction of at least 50% | Final value | Proportion | Week 12 |
| OUT-S2 | [Quality of life] | [Instrument] | [Metric] | [Aggregation] | [Weeks 4, 12, 26] |
4.7 Harms (item 17)
| Aspect | Approach |
|---|---|
| Definitions | Example: Adverse events coded with MedDRA [version]; graded with [CTCAE version] |
| Systematic assessment | [Structured symptom checklist at every visit; laboratory tests at weeks 4 and 12] |
| Non-systematic assessment | [Spontaneous reports by participants at any time] |
| Serious adverse events | Example: Reported to the sponsor within 24 hours of site awareness |
| Suspected unexpected serious adverse reactions | [Sponsor to regulator and ethics committee within the regulatory time frame] |
4.8 Participant timeline (item 18)
The schedule of enrolment, interventions and assessments is shown below (X = performed).
| Procedure | Screening (day -14 to -1) | Baseline (day 0) | Week 4 (+/- 3 days) | Week 12 (+/- 7 days) | Week 26 (+/- 14 days) |
|---|---|---|---|---|---|
| Eligibility screen | X | ||||
| Informed consent | X | ||||
| Randomisation | X | ||||
| Medical history | X | ||||
| Physical examination | X | X | X | ||
| [Primary outcome measure] | X | X | X | X | |
| [Blood tests] | X | X | X | ||
| Study drug dispensed | X | X | |||
| Adherence check | X | X | |||
| Harms assessment | X | X | X | X | |
| Concomitant medication review | X | X | X | X | X |
4.9 Sample size (item 19)
For a two-arm comparison of means with equal allocation:
where is the expected drop-out proportion. Example: , , two-sided , power 90% gives 85 per arm; with , the target is 95 per arm (190 in total).
| Assumption | Value | Source |
|---|---|---|
| Standard deviation | [10] | [Pilot data / published trial] |
| Minimal important difference | [5] | [Reference] |
| Alpha / power | [0.05 / 90%] | [Rationale] |
| Drop-out | [10%] | [Reference] |
4.10 Recruitment (item 20)
| Item | Plan |
|---|---|
| Sources | [Clinic lists, referrals, registries, advertising approved by ethics] |
| Expected rate | Example: 4 participants per site per month across 8 sites |
| Recruitment period | [18 months] |
| Feasibility evidence | [Audit of eligible patients in prior year] |
| Contingency | [Additional sites if below 70% of target at month 6] |
5. Methods: assignment of interventions
This section describes how participants are allocated and how bias is prevented.
5.1 Sequence generation (items 21a, 21b)
[Who generates the sequence and how (for example an independent statistician using computer-generated random numbers), the type of randomisation (simple or restricted) and stratification factors. Details of any blocking are held in a separate restricted document.]
5.2 Allocation concealment mechanism (item 22)
[Mechanism, for example a central 24-hour web randomisation service, with steps that keep the sequence hidden until assignment.]
5.3 Implementation (item 23)
| Task | Responsible | Access to sequence? |
|---|---|---|
| Generates the sequence | [Independent statistician] | Yes |
| Enrols participants | [Site investigators] | No |
| Assigns interventions | [Randomisation system] | System only |
5.4 Blinding (items 24a to 24c)
| Group | Blinded | Method |
|---|---|---|
| Participants | [Yes / No] | [Matching placebo] |
| Care providers | [Yes / No] | [Method] |
| Outcome assessors | [Yes / No] | [Method] |
| Data analysts | [Yes / No] | [Coded arms] |
Unblinding: Example: The site investigator may unblind a single participant through the randomisation system when knowledge of allocation is needed for clinical care. Each unblinding is logged and reported to the trial manager within 24 hours.
6. Methods: data collection, management and analysis
This section covers data collection, data management and the planned analyses.
6.1 Data collection methods (items 25a, 25b)
| Data | Instrument | Collected by | Quality measures |
|---|---|---|---|
| [Primary outcome] | [Validated scale, reference] | [Trained blinded assessor] | Example: Assessor certification, 10% double scoring |
| [Laboratory values] | [Central laboratory] | [Site nurse] | [Accredited laboratory] |
| [Harms] | [eCRF form] | [Investigator] | [Source verification] |
Retention (item 25b): [Plans to promote complete follow-up, for example visit reminders and travel reimbursement, and the outcome data to be collected from participants who discontinue or deviate from the intervention.]
6.2 Data management (item 26)
[Describe data entry (for example a validated electronic data capture system), coding, security and storage, double entry or range checks, query handling and database lock procedure. Refer to the data management plan and say where it can be obtained.]
6.3 Statistical methods (items 27a to 27d)
| Item | Method |
|---|---|
| Comparison of outcomes, including harms (27a) | Example: Linear mixed model, adjusted for baseline score and stratification factors; harms summarised with risk differences |
| Analysis populations (27b) | [All randomised participants in allocated arm; per-protocol as sensitivity] |
| Missing data (27c) | [Multiple imputation; sensitivity analyses under missing not at random] |
| Additional analyses (27d) | [Prespecified subgroups with interaction tests; sensitivity analyses] |
7. Methods: monitoring
This section covers the data monitoring committee, interim analyses and trial monitoring.
7.1 Data monitoring committee (items 28a, 28b)
| Item | Detail |
|---|---|
| DMC composition | [Independent clinician chair, second clinician, statistician] |
| Independence from sponsor and funder | [Statement; competing interests declared] |
| Role and reporting structure | [Reports recommendations to the trial steering committee] |
| Charter | [Reference and where it can be obtained] |
| Interim analyses | Example: One efficacy and safety review after 50% of participants complete week 12, Haybittle-Peto boundary |
| Access to interim results | [DMC and unblinded statistician only] |
| Final decision to terminate | [Trial steering committee on DMC recommendation, with sponsor] |
7.2 Trial monitoring (item 29)
[Frequency and procedures for monitoring trial conduct, for example a risk-based monitoring plan with central statistical monitoring monthly, on-site visits at each site after the first 3 participants and then annually, and 100% source data verification of consent and primary outcome. If there is no monitoring, explain why.]
8. Ethics
This section covers ethical approval, amendments, consent, confidentiality and post-trial care.
8.1 Research ethics approval (item 30)
[Plans for seeking approval from research ethics committees or institutional review boards, with references when obtained.]
8.2 Protocol amendments (item 31)
[How important protocol modifications will be communicated to investigators, ethics committees, regulators, participants, registries and journals.]
8.3 Consent or assent (items 32a, 32b)
[Who obtains informed consent or assent from potential participants or authorised proxies, and how; arrangements for participants who lack capacity; additional consent provisions for use of participant data and biological specimens in ancillary studies.]
8.4 Confidentiality (item 33)
[How personal information about potential and enrolled participants will be collected, shared and maintained to protect confidentiality before, during and after the trial, in line with applicable privacy law.]
8.5 Ancillary and post-trial care (item 34)
[Provisions for ancillary and post-trial care and for compensation of those harmed by participation.]
9. Appendices
Supporting documents that accompany the protocol:
| Appendix | Content |
|---|---|
| A | Informed consent form and participant information sheet (version and date) |
| B | Biological specimens: collection, laboratory evaluation and storage plan |
| C | Completed SPIRIT 2025 checklist with page references |
| D | Case report forms |
| E | List of sites |
| F | Glossary: [AE adverse event, DMC data monitoring committee, eCRF electronic case report form, PPI patient and public involvement, SAE serious adverse event] |
Standard and licence note
Based on the SPIRIT 2025 Statement: Chan A-W, Boutron I, Hopewell S, Moher D, Schulz KF, et al., SPIRIT 2025 statement: updated guideline for protocols of randomised trials, BMJ 2025;389:e081477 (https://doi.org/10.1136/bmj-2024-081477) and parallel publications, with the checklist at https://www.consort-spirit.org. The SPIRIT 2025 statement and checklist are published open access under the Creative Commons Attribution licence (CC BY 4.0, https://creativecommons.org/licenses/by/4.0/). This template follows the order of its 34 items (including the new open science section and the patient and public involvement item), paraphrased in original text, and reproduces no checklist wording; use the official checklist and its explanation and elaboration for the normative items. SPIRIT 2025 replaces SPIRIT 2013. This is a document format, not clinical, statistical or regulatory advice; follow local privacy law and your institution's documentation policy. Template licence: MIT.
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