Agent skill

Adaptive Trial Simulator

by aipoch in aipoch/medical-research-skills

Design and simulate adaptive clinical trials with interim analyses, decision rules, and operating-characteristic summaries; use when planning adaptive designs or comparing stopping, enrichment, or…

MITAuto-check passedResearch & Science

Install Adaptive Trial Simulator

skills CLI
$ npx skills add aipoch/medical-research-skills --skill adaptive-trial-simulator -a claude-code

Project install by default; add -g for ~/.claude/skills/.

GitHub CLI
$ gh skill install aipoch/medical-research-skills adaptive-trial-simulator --agent claude-code

Project scope by default; add --scope user for a personal install. Needs GitHub CLI 2.90.0 or later (public preview).

Manual copy
$ git clone --depth 1 https://github.com/aipoch/medical-research-skills.git skills-src && mkdir -p .claude/skills && cp -r skills-src/'scientific-skills/Protocol Design/adaptive-trial-simulator' .claude/skills/adaptive-trial-simulator && rm -rf skills-src

Use ~/.claude/skills/ instead of .claude/skills for a personal install. The folder must contain SKILL.md.

Claude Code skills documentation · loads skills from .claude/skills/

Facts

Skill name
adaptive-trial-simulator
GitHub stars
2k
Token cost
~3k tokens
SKILL.md length
1,263 words
Files
5 (incl. scripts, references)
Skills in repo
567
Repo updated
First seen
Licence
MIT

At a glance

Design and simulate adaptive clinical trials with interim analyses, decision rules, and operating-characteristic summaries; use when planning adaptive designs or comparing stopping, enrichment, or…

  • Works in 5 steps: Confirm the user objective, required… → Validate that the request matches the… → Use the packaged script path or the… → …
  • Planning adaptive designs
  • SKILL.md covers Quick Check, Audit-Ready Commands, When to Use and Workflow, plus 19 more sections
  • Runs Python scripts from its folder; calls python

What it does

Adaptive Trial Simulator is an agent skill from aipoch/medical-research-skills. Design and simulate adaptive clinical trials with interim analyses, decision rules, and operating-characteristic summaries; use when planning adaptive designs or comparing stopping, enrichment, or sample-size re-estimation strategies.

Its SKILL.md is about 3k tokens, which your agent loads only when the skill is triggered. The skill folder holds 6 other files, including scripts and reference files (for example `POLISH_CHANGELOG.md`, `eval_report_adaptive-trial-simulator_result.json` and `references/audit-reference.md`).

It sits in Research & Science, covering Experimental design and Clinical and healthcare research. The repository describes itself as: Hundreds of agent skills for medical research, including protocol design, data analysis, evidence insights, and academic writing. The licence is MIT.

When your agent uses it

  • Planning adaptive designs
  • Comparing stopping
  • Sample-size re-estimation strategies

Example prompts

  • “/adaptive-trial-simulator”

Requirements

  • Python 3

Workflow steps

5 steps, taken from the first numbered list in SKILL.md.

  1. Confirm the user objective, required inputs, and non-negotiable constraints before doing detailed work.
  2. Validate that the request matches the documented scope and stop early if the task would require unsupported assumptions.
  3. Use the packaged script path or the documented reasoning path with only the inputs that are actually available.
  4. Return a structured result that separates assumptions, deliverables, risks, and unresolved items.
  5. If execution fails or inputs are incomplete, switch to the fallback path and state exactly what blocked full completion.

What it can do on your machine

Read from SKILL.md and the folder at commit 686e09d. It shows what the files ask for, not the result of running them.

  • Tool permissions

    Pre-approves nothing: there is no allowed-tools line, so your agent's usual permission prompts apply.

    From allowed-tools in the SKILL.md frontmatter.

  • Runs code

    Ships 1 file in scripts/ (Python), which the agent can run.

    Shell commands in SKILL.md call:

    • python

    From the folder's file list and the shell code blocks in SKILL.md.

  • Network

    No URLs in SKILL.md.

    From URLs in SKILL.md, links to its own repository left out.

  • Credentials

    Names no API keys, tokens, secrets or passwords.

    From names ending in _API_KEY, _TOKEN, _SECRET, _KEY or _PASSWORD in SKILL.md.

Context cost

Adaptive Trial Simulator loads about 3k tokens when it runs, and up to ~3.2k if it reads all its reference files. Until then it costs about 65 tokens; SKILL.md has 1,263 words of instructions outside code blocks.

Always · name and description, kept in context so the agent knows when to use it
~65
When it runs · the whole SKILL.md, loaded when a task matches
~3k
With references · SKILL.md plus every file in references/, read only if the agent opens them
~3.2k

Estimates: characters ÷ 4, the usual rule of thumb; real counts depend on the model's tokenizer. Scripts and assets cost tokens only if the agent reads them.

Safety

Auto-check passed

The automated check found no risky patterns in SKILL.md.

Automated static check — not a guarantee. Review scripts before installing. It scans the text of SKILL.md for risky patterns (piping downloads into a shell, reading credential files, hidden Unicode, destructive commands); the scripts in this folder are not scanned.

SKILL.md

The full file from aipoch/medical-research-skills at commit 686e09d, republished under its MIT licence (© aipoch). 1,263 words, ~3,013 tokens.

Download SKILL.mdSave it as .claude/skills/adaptive-trial-simulator/SKILL.md (or your agent's skills folder). This skill also uses 4 other files; get the full folder from GitHub.
name
adaptive-trial-simulator
description
Design and simulate adaptive clinical trials with interim analyses, decision rules, and operating-characteristic summaries; use when planning adaptive designs or comparing stopping, enrichment, or sample-size re-estimation strategies.
license
MIT
author
AIPOCH

Source: https://github.com/aipoch/medical-research-skills

Adaptive Trial Simulator

Statistical simulation platform for designing and validating adaptive clinical trial designs in silico. Enables optimization of interim analysis strategies, sample size adaptation, and early stopping rules while maintaining Type I error control.

Quick Check

Use this command to verify that the packaged script entry point can be parsed before deeper execution.

bash
python -m py_compile scripts/main.py

Audit-Ready Commands

Use these concrete commands for validation. They are intentionally self-contained and avoid placeholder paths.

bash
python -m py_compile scripts/main.py
python scripts/main.py --help
python scripts/main.py --design group_sequential --n-simulations 50
python scripts/main.py --design adaptive_reestimate --n-simulations 25 --optimize

When to Use

  • Use this skill when the task is to Design and simulate adaptive clinical trials with interim analyses.
  • Use this skill for protocol design tasks that require explicit assumptions, bounded scope, and a reproducible output format.
  • Use this skill when the response must stay inside the documented task boundary instead of expanding into adjacent work.

Workflow

  1. Confirm the user objective, required inputs, and non-negotiable constraints before doing detailed work.
  2. Validate that the request matches the documented scope and stop early if the task would require unsupported assumptions.
  3. Use the packaged script path or the documented reasoning path with only the inputs that are actually available.
  4. Return a structured result that separates assumptions, deliverables, risks, and unresolved items.
  5. If execution fails or inputs are incomplete, switch to the fallback path and state exactly what blocked full completion.

Features

  • Design Simulation: Monte Carlo validation of adaptive designs
  • Sample Size Re-estimation: Adapt sample size based on interim data
  • Early Stopping Rules: Futility and efficacy boundary optimization
  • Type I Error Control: Validate alpha spending strategies
  • Multi-Arm Designs: Drop-the-loser and seamless Phase II/III
  • Power Optimization: Identify designs with maximum power efficiency

Usage

Basic Usage
text
# Run standard group sequential design
python scripts/main.py

# Adaptive design with sample size re-estimation
python scripts/main.py --design adaptive_reestimate

# Optimize design parameters
python scripts/main.py --optimize
Parameters
ParameterTypeDefaultRequiredDescription
--designstrgroup_sequentialNoTrial design type
--n-simulationsint10000NoNumber of Monte Carlo simulations
--sample-sizeint200NoInitial sample size per arm
--effect-sizefloat0.3NoEffect size (Cohen's d)
--alphafloat0.05NoType I error rate
--powerfloat0.80NoTarget statistical power
--interim-looksint1NoNumber of interim analyses
--spending-functionstrobrien_flemingNoAlpha spending function
--reestimate-methodstrpromising_zoneNoSample size re-estimation method
--outputstrresults.jsonNoOutput file path
--visualizeflagFalseNoGenerate visualization charts
--optimizeflagFalseNoSearch for optimal design parameters
Advanced Usage
text
# Full adaptive design with visualization
python scripts/main.py \
  --design adaptive_reestimate \
  --n-simulations 50000 \
  --sample-size 250 \
  --effect-size 0.35 \
  --interim-looks 2 \
  --spending-function obrien_fleming \
  --visualize \
  --output adaptive_results.json

Design Types

Design TypeDescriptionUse Case
Group SequentialFixed interim looks with stopping boundariesStandard adaptive trials
Adaptive Re-estimateSample size adjustment based on interim dataUncertain effect size
Drop the LoserMulti-arm trials dropping inferior armsPhase II dose selection

Spending Functions

FunctionCharacteristicsEarly Boundary
O'Brien-FlemingConservative earlyHigh Z-scores early
PocockAggressive earlyLower Z-scores throughout
Power FamilyModerate (ρ=3)Balanced approach

Output Example

json
{
  "design_config": {
    "design_type": "adaptive_reestimate",
    "sample_size_per_arm": 200,
    "effect_size": 0.3,
    "alpha": 0.05,
    "target_power": 0.8
  },
  "simulation_results": {
    "power": 0.8234,
    "type_i_error": 0.0481,
    "expected_sample_size": 385.2,
    "early_stop_rate": {
      "efficacy": 0.1523,
      "futility": 0.0841
    }
  }
}

Technical Difficulty: HIGH

References

⚠️ AI independent acceptance status: manual inspection required This skill requires:

  • Python 3.8+ environment
  • NumPy, SciPy, and Matplotlib packages
  • Understanding of clinical trial statistics

Dependencies

text
pip install -r requirements.txt
Requirements
numpy>=1.20.0
scipy>=1.7.0
matplotlib>=3.4.0

Risk Assessment

Risk IndicatorAssessmentLevel
Code ExecutionPython scripts with mathematical calculationsMedium
Network AccessNo network accessLow
File System AccessWrites simulation resultsLow
Instruction TamperingStatistical parameters could affect resultsMedium
Data ExposureNo sensitive data exposureLow

Security Checklist

  • No hardcoded credentials or API keys
  • No unauthorized file system access
  • Output does not expose sensitive information
  • Input parameters validated
  • Error messages sanitized
  • Dependencies audited

Prerequisites

text
pip install -r requirements.txt
python scripts/main.py --help

Evaluation Criteria

Success Metrics
  • Simulations run without errors
  • Type I error controlled at nominal level
  • Power estimates are accurate
  • Visualizations generated correctly
Test Cases
  1. Basic Simulation: Default parameters → Valid results
  2. Different Designs: All design types → Appropriate behavior
  3. Optimization Mode: --optimize flag → Finds optimal parameters
  4. Visualization: --visualize flag → Charts generated

Lifecycle Status

  • Current Stage: Draft
  • Next Review Date: 2026-03-15
  • Known Issues: Type checking warnings with numpy arrays
  • Planned Improvements:
    • Bayesian adaptive designs
    • Multi-arm multi-stage (MAMS) support
    • Enhanced visualization options

References

Available in references/:

  • Adaptive design statistical theory
  • Regulatory guidance documents
  • Alpha spending function literature
  • Sample size re-estimation methods

Limitations

  • Statistical Complexity: Requires biostatistics expertise
  • Simulation Time: Large simulations may take hours
  • Simplified Models: Does not capture all real-world complexities
  • Regulatory Consultation: Results should be validated with regulators

⚠️ DISCLAIMER: This tool provides simulation results for research and planning purposes only. All clinical trial designs should be reviewed by qualified biostatisticians and regulatory experts before implementation.

Output Requirements

Every final response should make these items explicit when they are relevant:

  • Objective or requested deliverable
  • Inputs used and assumptions introduced
  • Workflow or decision path
  • Core result, recommendation, or artifact
  • Constraints, risks, caveats, or validation needs
  • Unresolved items and next-step checks
Show full SKILL.md (508 more words)Show less

Error Handling

  • If required inputs are missing, state exactly which fields are missing and request only the minimum additional information.
  • If the task goes outside the documented scope, stop instead of guessing or silently widening the assignment.
  • If scripts/main.py fails, report the failure point, summarize what still can be completed safely, and provide a manual fallback.
  • Do not fabricate files, citations, data, search results, or execution outcomes.

Input Validation

This skill accepts requests that match the documented purpose of adaptive-trial-simulator and include enough context to complete the workflow safely.

Do not continue the workflow when the request is out of scope, missing a critical input, or would require unsupported assumptions. Instead respond:

adaptive-trial-simulator only handles its documented workflow. Please provide the missing required inputs or switch to a more suitable skill.

Response Template

Use the following fixed structure for non-trivial requests:

  1. Objective
  2. Inputs Received
  3. Assumptions
  4. Workflow
  5. Deliverable
  6. Risks and Limits
  7. Next Checks

If the request is simple, you may compress the structure, but still keep assumptions and limits explicit when they affect correctness.

When Not to Use

  • Do not proceed when required input files, identifiers, parameters, or context are missing — ask the user to provide them first.
  • Do not assume capabilities beyond this skill's declared scope when the user requests external operations or inferences.
  • Do not proceed without user confirmation when overwriting existing results, executing high-cost batch operations, or expanding task scope.

Required Inputs

FieldRequiredFormat/SourceExampleIf Missing
User task descriptionYesTextResearch question, writing goal, analysis objectiveStop and ask user to provide
Primary input materialDepends on taskText, file path, ID, table, or literaturePMID, PDF, CSV, DOCX, keywords, etc.Specify which material type is missing
Output preferenceNoTextLanguage, format, target journal, templateUse skill default format

Output Contract

  • Primary output: Structured result or target file aligned with this skill's objective.
  • Optional output: Intermediate check notes, issue list, supplementary suggestions, or generated file paths.
  • Format requirement: Unless the user specifies otherwise, prefer stable, reviewable Markdown or JSON; if the skill's bundled script requires a fixed format, use that format.
  • If partially complete: Must explicitly mark as PARTIAL and state which steps are completed and which remain.

Failure Handling

  • Missing critical input: Explicitly state which fields, files, or identifiers are missing and pause.
  • Script, template, or resource execution failure: Report the failing step, likely cause, and recovery suggestions — do not silently degrade.
  • Partial completion only: Return the verified portion first, then list remaining blockers and suggested next steps.

User Checkpoints

  • Before executing batch processing, overwriting files, long-running searches, or multi-stage generation, confirm scope and output format with the user.
  • Before proceeding when a key judgment is ambiguous, evidence is insufficient, or the workflow is entering the next stage, confirm with the user.

Quick Validation

  • Check that key scripts, templates, or reference file paths this skill depends on exist.
  • Check that the final output contains the core fields, sections, or files specified for this task.
  • Check that results clearly mark assumptions, limitations, and incomplete items.

© aipoch, MIT. Rendered from Markdown: HTML in the file is shown as text, images as links, and headings moved down two levels. Raw file

Files

SKILL.md and 4 other files (scripts, references) in scientific-skills/Protocol Design/adaptive-trial-simulator of aipoch/medical-research-skills.

  • SKILL.md
  • POLISH_CHANGELOG.md
  • eval_report_adaptive-trial-simulator_result.json
  • references/audit-reference.md
  • scripts/main.py

Open the folder on GitHubat commit 686e09d

Compare with similar skills

Adaptive Trial Simulator next to the 5 skills that share the most tags, products or categories with it. Stars are the repository's; “used in” counts other GitHub owners with a copy.

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Clinical Researchalirezarezvani/claude-skills28k—~2.7kAutomated safety check: PassMIT
Clinical Researchborghei/Claude-Skills881—~3.6kAutomated safety check: PassMIT
Bio Clinical Biostatistics Adaptive DesignsGPTomics/bioSkills1.2k2 repos~7.7kAutomated safety check: PassMIT
Bio Clinical Biostatistics Power Sample SizeGPTomics/bioSkills1.2k2 repos~7.9kAutomated safety check: PassMIT

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Questions about Adaptive Trial Simulator

What does Adaptive Trial Simulator do?

Design and simulate adaptive clinical trials with interim analyses, decision rules, and operating-characteristic summaries; use when planning adaptive designs or comparing stopping, enrichment, or…. Adaptive Trial Simulator is an agent skill from aipoch/medical-research-skills. Design and simulate adaptive clinical trials with interim analyses, decision rules, and operating-characteristic summaries; use when planning adaptive designs or comparing stopping, enrichment, or sample-size re-estimation strategies.

When should I use Adaptive Trial Simulator?

Adaptive Trial Simulator fits situations like: planning adaptive designs; comparing stopping; sample-size re-estimation strategies.

How do I install Adaptive Trial Simulator in Claude Code?

Run `npx skills add aipoch/medical-research-skills --skill adaptive-trial-simulator -a claude-code`. Or copy the skill folder (scientific-skills/Protocol Design/adaptive-trial-simulator in aipoch/medical-research-skills) into .claude/skills/adaptive-trial-simulator in your project. Claude Code loads it when a task matches its description.

How do I install Adaptive Trial Simulator in Codex?

Run `npx skills add aipoch/medical-research-skills --skill adaptive-trial-simulator -a codex`. Or copy the skill folder (scientific-skills/Protocol Design/adaptive-trial-simulator in aipoch/medical-research-skills) into .agents/skills/adaptive-trial-simulator in your project. Codex loads it when a task matches its description.

Can I use Adaptive Trial Simulator in Cursor, Gemini CLI or GitHub Copilot?

Cursor, Gemini CLI, GitHub Copilot and OpenCode also load SKILL.md folders. With the skills CLI, run `npx skills add aipoch/medical-research-skills --skill adaptive-trial-simulator -a cursor` (or -a gemini-cli, github-copilot or opencode for the others). To copy it by hand, put the folder in .cursor/skills/adaptive-trial-simulator, .gemini/skills/adaptive-trial-simulator, .github/skills/adaptive-trial-simulator and .opencode/skills/adaptive-trial-simulator in your project.

What does Adaptive Trial Simulator need to run?

Going by SKILL.md and its folder, Adaptive Trial Simulator needs Python for the scripts in its folder and the command-line tools its instructions call (python). Our summary lists: Python 3.

Does Adaptive Trial Simulator access the network?

SKILL.md contains no URLs. Any network use would come from the scripts or tools the agent runs. This is read from the text; nothing was executed.

Is Adaptive Trial Simulator safe to install?

Our automated static check of SKILL.md found no risky patterns, such as piping downloads into a shell, reading credential files or hidden Unicode. It is not a guarantee. The check reads SKILL.md only: the scripts in the folder are not scanned, so read them before running anything.

What licence does Adaptive Trial Simulator use?

Adaptive Trial Simulator is published under the MIT licence (declared in SKILL.md). It allows redistribution, so the full SKILL.md is shown on this page.

How many tokens does Adaptive Trial Simulator use?

About 3k tokens (SKILL.md is roughly 12k characters). Agents keep only the skill's name and description in context until a task matches; then they load SKILL.md in full. Its references folder adds about 162 tokens, read only when the agent opens those files.

What are the alternatives to Adaptive Trial Simulator?

Skills that share tags, products or a category with Adaptive Trial Simulator: Clinical Protocol Drafting (aws-samples/amazon-bedrock-agents-healthcare-lifesciences, 274 stars), Clinical Research (alirezarezvani/claude-skills, 28k stars), Clinical Research (borghei/Claude-Skills, 881 stars) and Bio Clinical Biostatistics Adaptive Designs (GPTomics/bioSkills, 1.2k stars). The comparison table on this page puts their stars, adoption, token cost, safety result and licence side by side.

Who maintains Adaptive Trial Simulator?

aipoch (a GitHub organization) maintains it in aipoch/medical-research-skills, which has 1,974 GitHub stars. The repository holds 567 skills in this directory. The repository was last updated on September 17, 2026.

Source: aipoch/medical-research-skills on GitHub. Facts on this page come from the repository at the commit we read; the author's words are quoted as theirs.