Rigor Reviewed

Rigor-Reviewed Manuscript

Low concentration atropine eye drops and progression of myopia in children: multicentre placebo controlled, double masked, randomised trial in the UK (CHAMP-UK).

Name: Adcurare Rigor Record — Low concentration atropine eye drops and progression of myopia in children: multicentre placebo controlled, double masked, randomised trial in the UK (CHAMP-UK).
Item: Low concentration atropine eye drops and progression of myopia in children: multicentre placebo controlled, double masked, randomised trial in the UK (CHAMP-UK).
Rating: 100
Author: Adcurare

Azuara-Blanco A, Logan NS, McConnell E, Kearney S, Kirk G, Jones S, McDowell C, Murphy L, O'Hanlon G, McFarland M, Painter S, Muthusamy B, Nabili S, Preston J, Flitcroft I, Loughman J, Mackey D, Lee S, Dahlmann-Noor A, Congdon N, Hogg RE, Hammond CJ, Saunders K, Allen PM, Strang N, Clarke M

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Adcurare Rigor Review — 4★ (Strong), 0 critical, 0 high issues for “Low concentration atropine eye drops and progression of myopia in children: multicentre placebo controlled, double masked, randomised trial in the UK (CHAMP-UK).”

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Adcurare Editorial

This rigor review was examined and confirmed by Adcurare Editorial · July 6, 2026

Adcurare Rigor Review

Rigor Reviewed

4 / 5

Strong — minor issues to address

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

IntegrityIntegrity concern ×2−1★

Model-reported confidence: highReviewer agreement: highEngine: 7.6.0Source: full text

Problems surfaced1 type

Internal contradictions in the reported numbers

This Adcurare Rigor Review uses AI Rigor Reviewers trained on a curated corpus of high-fidelity and retracted papers, with expert supervision and curation. It can still make mistakes; verify each finding against the source before relying on it.

This is a well-designed and transparently reported multicentre RCT. Key strengths include pre-registration, a publicly available dataset with code, detailed reporting of methods and results, and thorough disclosure of limitations. Minor issues include the absence of an explicit CONSORT guideline citation, a very small internal inconsistency in Table 1 ethnicity counts, and the code being in supplemental files rather than a version-controlled repository.

Three independent rigor evaluations (all scored all eight dimensions) plus a copyedit pass and verification components (citations, statistics, reproducibility, preregistration, integrity, claim audit) were synthesized. The reviewers agreed on all dimension-level statuses, with minor divergences at the sub-criterion level. Coverage caveats: statistics verification checked only 5 tests with sufficient detail; all other reported statistics remain unverified. Citation verification found no retracted or missing references.

12 major claims checked against the paper's own evidence: all adequately supported.

Recomputed 5 tests: 5 consistent, 0 inconsistent, 5 via agent-written checks.

2 integrity concerns flagged (0 high).

Reporting

Eight Dimensions8 pass

The introduction cites prior epidemiological trends, a Cochrane review highlighting uncertainties, and gaps in evidence for Western populations. The rationale directly follows: atropine is used worldwide but not available in the UK NHS, and existing trials have variable results. Limitations of prior research (e.g., small samples in European studies, lack of objective adherence monitoring) are explicitly discussed and addressed in the study design.

Sub-criteria

prior work citedADEQUATE

premise rationaleADEQUATE

limitations addressedADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

The study clearly establishes its scientific foundation with extensive prior work cited, a logical rationale linking premise to objectives, and limitations of prior research addressed.

Evidence

direct quote[Introduction, paragraph 3]

“A recent Cochrane review found that high concentration atropine (≥0.5%) may be the most effective treatment option, but the side effects ... render it unsuitable for routine clinical interventions to control myopia.”

direct quote[Introduction, paragraph 4]

“In the CHAMP-UK (Childhood Atropine for Myopia Progression in the UK) study we evaluated the efficacy, safety, and mechanism of action of low concentration atropine (0.01%) in UK children with myopia aged 6 to 12 years.”

direct quote[Discussion, 'Strengths and limitations of this study']

“Limitations of previously published studies include smaller sample sizes and a lack of an objective measure of eye drop use, with typically calendar review and parental report used to record adherence to eye drop use.”

PASSReviewer 2· 95% conf

The scientific premise is well-established with extensive citation of prior research and a clear rationale for the study.

Evidence

direct quote[Introduction]

“In Europe, the prevalence of myopia has increased noticeably over the past few decades.”

direct quote[Introduction]

paraphrase[Introduction]

“The CHAMP-UK study was designed to evaluate efficacy and safety of low concentration atropine in UK children.”

PASSReviewer 3· 95% conf

The paper clearly establishes the scientific premise for the trial, citing prior work on myopia prevalence, the limitations of existing interventions (especially side effects of high-concentration atropine), and the uncertainty about low-concentration atropine in European populations.

Evidence

direct quote[Introduction, paragraphs 1-4]

“A recent Cochrane review found that high concentration atropine (≥0.5%) may be the most effective treatment option, but the side effects (photophobia, blurred vision at near reading distance, and allergic reactions) render it unsuitable for routine clinical interventions to control myopia. The review highlighted uncertainties about the comparative effectiveness of available interventions.”

direct quote[Introduction, paragraph 5]

“Although most trials using atropine for myopia control have been conducted in children of Chinese ethnicity, several recent studies have examined low concentration atropine in western populations, with variable results. In addition, atropine eye drops are not available in the UK National Health Service (NHS) for treating myopia.”

paraphrase[Introduction, final paragraph]

“The CHAMP-UK study was designed to evaluate efficacy, safety, and mechanism of action of low concentration atropine (0.01%) in UK children, directly addressing the gap identified in the prior literature.”

Randomisation was computer-generated using a minimisation algorithm (2:1), with allocation concealed from recruitment staff. Unit is individual participant. Double-masking is described explicitly (participants, investigators, monitors all masked). A power analysis with sample size justification is present (90% power to detect 40% reduction, accounting for 15% dropout). Inclusion/exclusion criteria are pre-specified and detailed. Outlier handling is addressed via sensitivity analyses with extreme value imputation and complete-case primary analysis. Controls (placebo) and independent replication (comparison with other trials) are not applicable for a human RCT; replicate distinction is also n/a. Blinding levels are adequate.

Sub-criteria

controlsN/A

power analysisADEQUATE

blinding levelsADEQUATE

outlier handlingADEQUATE

randomization unitADEQUATE

inclusion exclusionADEQUATE

randomization methodADEQUATE

replicate distinctionN/A

independent replicationN/A

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

The design is rigorous: randomisation method, unit, blinding, sample size calculation, inclusion/exclusion criteria, and handling of missing data are all adequately reported.

Evidence

direct quote[Methods, 'Recruitment, randomisation, and allocation']

“Randomisation (2:1) was computer generated using a minimisation algorithm to ensure balanced allocation of participants across the two treatment groups.”

direct quote[Methods, 'Recruitment, randomisation, and allocation']

“Investigators (chief, principal, and co-investigators), study monitors, and study participants were all masked throughout the study.”

direct quote[Methods, 'Sample size']

PASSReviewer 2· 95% conf

The study design is rigorous with adequate randomization, blinding, sample size justification, and clear inclusion/exclusion criteria.

Evidence

direct quote[Methods: Recruitment, randomisation, and allocation]

“Randomisation (2:1) was computer generated using a minimisation algorithm to ensure balanced allocation of participants across the two treatment groups.”

direct quote[Methods: Recruitment, randomisation, and allocation]

“Investigators (chief, principal, and co-investigators), study monitors, and study participants were all masked throughout the study.”

direct quote[Methods: Sample size]

“Considering a dropout rate of 15% and that 10% of recruited children could be Chinese, we increased the number required to a total of 289 participants: 193 in the atropine group and 96 in the placebo group, to detect this difference in the non-Chinese UK population with 90% power.”

PASSReviewer 3· 95% conf

The trial design is robust: randomised, double-masked, placebo-controlled, with computer-generated minimisation, full allocation concealment, pre-specified eligibility criteria, a power analysis, and an intention-to-treat analysis. Blinding is described and appropriate for a drug trial.

Evidence

direct quote[Methods, Recruitment, randomisation, and allocation]

“Randomisation (2:1) was computer generated using a minimisation algorithm to ensure balanced allocation of participants across the two treatment groups. A participant’s allocation was fully concealed from everyone involved in recruiting participants to the trial.”

direct quote[Methods, Recruitment, randomisation, and allocation]

“Investigators (chief, principal, and co-investigators), study monitors, and study participants were all masked throughout the study.”

direct quote[Methods, Sample size]

“With a standard deviation (SD) of 0.7, an intraclass correlation coefficient between the two eyes of 0.9, and a variation inflation factor of 1.9, we determined that we would need 228 participants (456 eyes). Considering a dropout rate of 15% and that 10% of recruited children could be Chinese, we increased the number required to a total of 289 participants: 193 in the atropine group and 96 in the placebo group, to detect this difference in the non-Chinese UK population with 90% power.”

Sex, age, weight, height, ethnicity, parental myopia, and baseline myopia severity are reported in Table 1. Health status is addressed through exclusion criteria. For a human RCT, species/strain and housing are not applicable.

Sub-criteria

demographicsADEQUATE

sex reportedADEQUATE

sex justifiedN/A

age weight healthADEQUATE

housing conditionsN/A

species strain sourceN/A

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 90% conf

Biological variables (sex, age, weight, health status, demographics) are thoroughly reported in Table 1. Sex is reported for both sexes and mixed; justification is not required.

Evidence

direct quote[Table 1]

“Girl: 102 (53%) [atropine group] / 59 (61%) [placebo] / 161 (56%) [total]”

direct quote[Table 1]

“Mean (SD) age (years): 9.3 (1.7) [both groups]”

direct quote[Table 1]

“White: 136 (70%) [atropine group] / 71 (73%) [placebo] / 207 (72%) [total]”

PASSReviewer 2· 95% conf

Key biological variables including sex, age, weight, and ethnicity are reported. Sex is not justified because both sexes are included.

Evidence

direct quote[Abstract and Table 1]

“161 (56%) were girls”

direct quote[Table 1]

“Mean (SD) age (years) 9.3 (1.7); Mean (SD) weight (kg) 36.4 (11.2); Mean (SD) height (cm) 141.2 (12.8)”

direct quote[Table 1]

“White 136 (701); Mixed/multiple ethnic groups 13 (7); Asian/Asian British (excluding Chinese) 26 (13); Black/African/Caribbean/black British 2 (1); Chinese 8 (4); Other 7 (4)”

PASSReviewer 3· 95% conf

Age, sex, weight, height, and ethnicity are reported in detail for both groups. The study includes both sexes; a single-sex justification is not needed. Species/strain and housing conditions are not applicable for a human trial. Demographics are fully reported.

Evidence

direct quote[Table 1]

“Mean (SD) age (years): 9.3 (1.7); Sex: Girl: 161 (56%); Mean (SD) weight (kg): 36.1 (10.7); Mean (SD) height (cm): 141.3 (12.3); White: 207 (72%).”

direct quote[Results, paragraph 1]

“207 (72%) reported white ethnicity, 161 (56%) were girls.”

The paper explicitly states ethics approval by the Office for Research Ethics Committees Northern Ireland (reference 18/NI/0164). Parental consent is mentioned: 'After parental consent had been obtained, children were screened and, if eligible, enrolled and randomised.' Regulatory compliance is stated with the European Clinical Trials Directive 2001/20/EC. All applicable criteria (irb_ethics_statement, informed_consent, regulatory_compliance) are reported adequately.

Sub-criteria

iacuc statementN/A

informed consentADEQUATE

irb ethics statementADEQUATE

regulatory complianceADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

Ethical approval from a named committee (ORECNI) with reference number is stated; parental informed consent is described; regulatory compliance with the European Clinical Trials Directive is noted.

Evidence

direct quote[Ethics statements]

“CHAMP-UK (Childhood Atropine for Myopia Progression in the UK) was reviewed and approved by the Office for Research Ethics Committees Northern Ireland (reference 18/NI/0164).”

direct quote[Methods, 'Recruitment, randomisation, and allocation']

“After parental consent had been obtained, children were screened and, if eligible, enrolled and randomised.”

direct quote[Methods, 'Adverse events and safety reporting']

“Serious adverse events related to the use of the study drugs in the trial were reported in accordance with the guidance from the European Clinical Trials Directive 2001/20/EC.”

PASSReviewer 2· 95% conf

Ethics approval from a named committee is provided, informed consent is described, and regulatory compliance is stated.

Evidence

direct quote[Ethics statements]

“CHAMP-UK was reviewed and approved by the Office for Research Ethics Committees Northern Ireland (reference 18/NI/0164).”

direct quote[Methods: Recruitment, randomisation, and allocation]

“After parental consent had been obtained, children were screened and, if eligible, enrolled and randomised.”

direct quote[Methods: Adverse events and safety reporting; Methods: Monitoring and protocol adherence]

“Serious adverse events related to the use of the study drugs in the trial were reported in accordance with the guidance from the European Clinical Trials Directive 2001/20/EC”

PASSReviewer 3· 90% conf

Ethical approval is stated with a named ethics committee and reference number. Informed consent is implied by the recruitment process (parental consent obtained). Regulatory compliance with the European Clinical Trials Directive is stated.

Evidence

direct quote[Ethics statements]

“CHAMP-UK (Childhood Atropine for Myopia Progression in the UK) was reviewed and approved by the Office for Research Ethics Committees Northern Ireland (reference 18/NI/0164).”

direct quote[Methods, Recruitment, randomisation, and allocation]

“After parental consent had been obtained, children were screened and, if eligible, enrolled and randomised.”

direct quote[Methods, Adverse events and safety reporting]

“Serious adverse events related to the use of the study drugs in the trial were reported in accordance with the guidance from the European Clinical Trials Directive 2001/20/EC.”

The atropine formulation is described: 'preserved atropine sulfate 0.01% eye drops' with preservative benzalkonium chloride 0.01% w/v. The placebo is identical. The manufacturer of the drug is stated: Stockport Pharmaceuticals. The MEMS device is identified (AARDEX Group, Switzerland). The autorefractor models are listed. Statistical software is identified (Stata version 15.1). The clinical trial database is identified (MACRO release 4.9.1). All these are reported_and_adequate. Reagents_identified applies to the investigational product.

Sub-criteria

mycoplasma testingN/A

reagents identifiedADEQUATE

organisms identifiedN/A

antibodies identifiedN/A

cell line authenticationN/A

software tools identifiedADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 90% conf

The investigational product (atropine 0.01% and placebo) is identified with manufacturer, formulation, and preservative details. Software tools are identified with name and version. No antibodies, cell lines, or organisms used, so those are n/a.

Evidence

direct quote[Methods, 'Study interventions']

“The intervention group was assigned to receive preserved atropine sulfate 0.01% eye drops once daily at bedtime in both eyes for two years.”

direct quote[Methods, 'Statistical analysis']

“Analyses were performed with Stata Statistical Software, version 15.1 (StataCorp, College Station, TX).”

direct quote[Methods, 'Study interventions']

“The control group received placebo eye drops on the same dosing schedule, with the same preservative (benzalkonium chloride 0.01% weight/volume in sterile water) and pH.”

PASSReviewer 2· 90% conf

The investigational product (atropine) is identified with source, and software tools are named with versions.

Evidence

direct quote[Acknowledgments]

“The study drug was developed and supplied by Stockport Pharmaceuticals”

direct quote[Methods: Statistical analysis]

“Analyses were performed with Stata Statistical Software, version 15.1 (StataCorp, College Station, TX).”

PASSReviewer 3· 90% conf

The investigational product (atropine 0.01% eye drops) is described with manufacturer and formulation. The placebo is described. Autorefractors and other instruments are named with models. Software tools are identified. Antibodies, cell lines, mycoplasma testing, and organisms are not applicable for this human drug trial.

Evidence

direct quote[Methods, Study interventions; Acknowledgements]

“The intervention group was assigned to receive preserved atropine sulfate 0.01% eye drops once daily at bedtime in both eyes for two years. The control group received placebo eye drops on the same dosing schedule, with the same preservative (benzalkonium chloride 0.01% weight/volume in sterile water) and pH.”

direct quote[Methods, Statistical analysis]

“Analyses were performed with Stata Statistical Software, version 15.1 (StataCorp, College Station, TX).”

direct quote[Methods, Outcomes]

“Adherence was assessed using electronic monitoring with a medical events monitoring system (MEMS) device (AARDEX Group, Switzerland).”

Tests named include GEE, independent t-test, ANCOVA, χ² tests, repeated measures mixed models. Exact p-values reported (e.g., P<0.001, P=0.003). Effect sizes and 95% CIs are reported for all primary and secondary outcomes. Statistical software is identified (Stata 15.1). Data presentation: Table 2 provides per-group n, means, SDs, and CIs. Individual data points are not shown but this is a clinical trial, so the CONSORT-type presentation is adequate. Assumptions_verified is adequate for a human trial using standard methods (GEE, mixed models). Mathematical_plausibility: no demonstrable arithmetic errors were detected in the reported data (e.g., baseline means and SDs plausible, percentages sum appropriately within rounding).

Sub-criteria

tests namedADEQUATE

exact p valuesADEQUATE

effect sizes ciADEQUATE

data presentationADEQUATE

software identifiedADEQUATE

assumptions verifiedADEQUATE

mathematical plausibilityPASS

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 90% conf

Statistical tests are named, exact p-values are reported, effect sizes with 95% CIs are provided, software is identified, data presentation includes per-group n and definition of error terms. Assumptions are handled by design (GEE, mixed models). Mathematical plausibility is adequate.

Evidence

direct quote[Abstract and Results]

“mean difference 0.33 D, 95% confidence interval (CI) 0.17 to 0.49 D, P<0.001”

direct quote[Methods, 'Statistical analysis']

“We compared the atropine and control groups using generalised estimating equations and 95% confidence intervals (CIs) to allow for the correlation between eyes within a participant.”

direct quote[Methods, 'Statistical analysis']

“Analyses were performed with Stata Statistical Software, version 15.1 (StataCorp, College Station, TX).”

PASSReviewer 2· 90% conf

Statistical methods are appropriate and well-described, with exact p-values and confidence intervals reported.

Evidence

direct quote[Methods: Statistical analysis]

“We compared the atropine and control groups using generalised estimating equations and 95% confidence intervals (CIs) to allow for the correlation between eyes within a participant.”

direct quote[Results, Table 2]

“Mean difference 0.33 D, 95% confidence interval (CI) 0.17 to 0.49 D, P<0.001”

PASSReviewer 3· 90% conf

Statistical methods are thorough and well-described: GEE for correlated eye data, ANCOVA, t-tests, χ² tests, mixed models, pre-specified subgroup analyses with interaction terms, and sensitivity analyses for missing data. Exact p-values and 95% CIs are reported. Software is named. Data presentation includes tables with per-group n, mean, SD, and CIs.

Evidence

direct quote[Table 2 and Methods, Statistical analysis]

“Atropine eye drops were more effective than placebo in reducing myopia progression (mean difference 0.33 D, 95% confidence interval (CI) 0.17 to 0.49 D, P<0.001).”

direct quote[Methods, Statistical analysis]

“Analyses were performed with Stata Statistical Software, version 15.1 (StataCorp, College Station, TX).”

direct quote[Table 2]

“Intention to treat: atropine: −0.39 (0.63); n=151; placebo: −0.70 (0.67); n=79.”

The data availability statement states: 'The data underlying the findings in this paper are openly and publicly available and can be found here: https://doi.org/10.25934/PR00013003 .' This is a concrete route with a DOI. The code used to analyse the data is stated to be in the supplemental files. Repository_deposit is adequate (DOI). Accession_numbers are n/a (no sequencing data). Code_sharing is reported_and_adequate: 'The code used to analyse the data in the paper can be found in the supplemental files.' The DOI link and supplemental code are explicit.

Sub-criteria

code sharingADEQUATE

accession numbersN/A

repository depositADEQUATE

data availability statementADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

Data availability statement is concrete with a DOI to a public repository. Code is shared in supplemental files. Repository deposit is adequate with a persistent DOI. Accession numbers are not applicable.

Evidence

direct quote[Data availability statement]

“The data underlying the findings in this paper are openly and publicly available and can be found here: https://doi.org/10.25934/PR00013003 .”

direct quote[Data availability statement]

“The code used to analyse the data in the paper can be found in the supplemental files.”

PASSReviewer 2· 90% conf

Data are openly available with a DOI, and analysis code is provided in supplemental files.

Evidence

direct quote[Data availability statement]

“The data underlying the findings in this paper are openly and publicly available and can be found here: https://doi.org/10.25934/PR00013003”

direct quote[Data availability statement]

“The code used to analyse the data in the paper can be found in the supplemental files.”

PASSReviewer 3· 90% conf

Data availability statement is present and adequate: data are openly available via a DOI. Code is shared in supplemental files. This is a strong open-science practice.

Evidence

direct quote[Data availability statement]

“The data underlying the findings in this paper are openly and publicly available and can be found here: https://doi.org/10.25934/PR00013003.”

direct quote[Data availability statement]

“The code used to analyse the data in the paper can be found in the supplemental files.”

Methods are detailed enough for replication (dosing, timing, measurements, statistical methods). The trial is registered with two registries (ISRCTN99883695, NCT03690089). No explicit reporting checklist (CONSORT) is referenced in the methods, but the paper follows CONSORT-like structure and includes a flow diagram (Fig 1). All outcomes listed in the Methods are reported in the Results. Limitations are discussed in a dedicated section (Strengths and limitations), including adherence, generalisability, subgroup power, the COVID-19 pandemic, and unvalidated tolerability questionnaire. Conclusions are appropriately cautious: 'should be considered as an alternative to manage myopia progression' — not overclaiming causation. Funding (NIHR EME) and competing interests are comprehensively disclosed.

Sub-criteria

funding coiADEQUATE

trial registrationADEQUATE

reporting guidelineINADEQUATE

methods completenessADEQUATE

all outcomes reportedADEQUATE

limitations discussedADEQUATE

conclusions proportionalADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 90% conf

Methods are detailed enough for replication, trial is registered, negative/null outcomes are reported, limitations are discussed, conclusions are proportional to evidence, and funding/COI are provided. No reporting guideline checklist referenced explicitly, but the paper follows CONSORT-like structure, and this is a minor gap.

Evidence

direct quote[Abstract and Methods]

“Trial registration ISRCTN registry ISRCTN99883695, ClinicalTrials.gov NCT03690089”

direct quote[Discussion, 'Strengths and limitations of this study']

direct quote[Funding and Competing interests sections]

“Funding: National Institute for Health and Care Research Efficacy and Mechanism Evaluation (project 15/48/59).”

PASSReviewer 2· 90% conf

The study is transparently reported with detailed methods, registration, limitations, and funding. Reporting guideline not explicitly mentioned.

Evidence

direct quote[Abstract]

“Trial registration ISRCTN registry ISRCTN99883695, ClinicalTrials.gov NCT03690089”

direct quote[Discussion]

absence[Methods]

No reporting guideline is mentioned.

PASSReviewer 3· 95% conf

The manuscript is comprehensive: methods are replicable, the trial is registered, all outcomes are reported, limitations are discussed, conclusions are proportional to the evidence, and funding/COIs are disclosed.

Evidence

direct quote[Abstract, Methods]

“Trial registration ISRCTN registry ISRCTN99883695, ClinicalTrials.gov NCT03690089.”

direct quote[Discussion, Strengths and limitations of this study]

“A limitation of the current study is that as it is an efficacy trial, with adherence assessed by MEMS device, the generalisability of these findings to non-trial settings without the advantage of objective monitoring of adherence is unknown. In addition, subgroup analyses were underpowered to be able to detect differences; tolerability was not assessed with a validated questionnaire; the covid-19 pandemic occurred during the current study timeline...”

direct quote[Conclusions]

“Low concentration 0.01% atropine treatment was well tolerated and effective and should be considered as an alternative to manage myopia progression.”

7 copyedit issues flagged (1 major): mostly consistency, clarity, typo.

Checked 50 references: 47 verified — 3 not checked.

Reproducibility

3 data/code links checked; 2 live.

Registered (2 IDs: ClinicalTrials.gov, ISRCTN). No reporting guideline cited.

Adcurare Rigor Action ItemsFinal pass before journal submission

Ready after minor edits. The manuscript is rigorous and transparent. Address the copyedit typos (Table 1 '701' → '70%', Table 5 missing parenthesis, stray 'c'), add a CONSORT checklist citation, and consider moving analysis code to a public repository before submission.

1.
MEDIUMcopyedit
Table 1: Fix the 'White' ethnicity entry for the atropine group from '136 (701)' to '136 (70%)' or '136 (71%)' as appropriate for the denominator.
The percentage is clearly a typo (701 is not a valid percentage value) and will be flagged by any copy editor or reviewer.
2.
MEDIUMcopyedit
Table 5, per protocol analysis, sex row: Add the missing closing parenthesis in the SD value — change '−0.35 (0.630' to '−0.35 (0.63)'.
The unbalanced parenthesis is a formatting error that could confuse readers.
3.
MEDIUMcopyedit
Table 5, 'Iris colour: Other‡ c': Remove the stray extra character 'c' after the double dagger symbol.
This is a typographical error that makes the table look unprofessional.
4.
MEDIUMreporting
Explicitly cite the CONSORT reporting guideline in the Methods section (e.g., 'We followed CONSORT guidelines for reporting randomised trials.') and include the completed checklist as a supplement.
Although the paper follows CONSORT structure, the absence of an explicit citation is a transparency gap that editors and reviewers may flag.
5.
MEDIUMdata code
Deposit the analysis code in a version-controlled public repository (e.g., GitHub with a DOI via Zenodo) and update the data availability statement to point to both the repository and the repository DOI instead of or in addition to the supplemental files.
Supplemental files are less discoverable, less version-controlled, and less citable than a dedicated repository; this improves reproducibility and compliance with open-science standards.
6.
LOWreporting
Table 1: Clarify the minor discrepancy between the minimisation factor 'White' total (209) and the detailed ethnicity 'White' total (207) by adding a footnote or correcting the tabulation.
This small internal inconsistency (likely a rounding or categorization artifact) could confuse attentive readers during review.
7.
LOWstatistics
Explicitly state whether any formal tests for normality, homoscedasticity, or other assumptions were performed for the parametric models (ANCOVA, t-test, GEE), even if robust methods were used.
Adding a sentence on assumption checks strengthens the statistical analysis section and pre-empts a common reviewer query.

Full text (58,427 chars)Analyzed: Jul 6, 2026

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Low concentration atropine eye drops and progression of myopia in children: multicentre placebo controlled, double masked, randomised trial in the UK (CHAMP-UK).

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Journal

DOI

10.1136/bmj-2025-086698

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Issued Jul 6, 2026Engine 7.6.0

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