Rigor Reviewed

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Long acting progestogens versus combined oral contraceptive pill for preventing recurrence of endometriosis related pain: the PRE-EMPT pragmatic, parallel group, open label, randomised controlled trial.

Name: Αlpha¹ Rigor Record — Long acting progestogens versus combined oral contraceptive pill for preventing recurrence of endometriosis related pain: the PRE-EMPT pragmatic, parallel group, open label, randomised controlled trial.
Item: Long acting progestogens versus combined oral contraceptive pill for preventing recurrence of endometriosis related pain: the PRE-EMPT pragmatic, parallel group, open label, randomised controlled trial.
Rating: 96
Author: Αlpha¹

Cooper KG, Bhattacharya S, Daniels JP, Horne AW, Clark TJ, Saridogan E, Cheed V, Pirie D, Melyda M, Monahan M, Roberts TE, Cox E, Stubbs C, Middleton LJ, PRE-EMPT Collaborative Group

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Αlpha¹ Rigor Review — 3.25★ (Adequate), 0 critical, 3 high issues for “Long acting progestogens versus combined oral contraceptive pill for preventing recurrence of endometriosis related pain: the PRE-EMPT pragmatic, parallel group, open label, randomised controlled trial.”

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Αlpha¹ Editorial

This rigor review was examined and confirmed by Αlpha¹ Editorial · August 16, 2026

Αlpha¹ Rigor Review

Rigor Reviewed

3.25 / 5

Adequate — real issues to address

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

IntegrityIntegrity concern−0.5★
ClaimsEfficacy rests on an unvalidated surrogate endpoint−0.5★
ClaimsTreatment effect not shown to be clinically meaningful−0.5★
ReportingData & code availability partially met−0.25★

Model-reported confidence: highReviewer agreement: highEngine: 7.39.0Source: full text

Not verified in this report

The numeric-impossibility checks (GRIM/GRIMMER/DEBIT/SPRITE) did not run: 64 reported means were read, and their group size is not stated where the values are printed (this source has no machine-readable table structure). These checks need the count the mean was averaged over, so none was performed.
No data or code availability links were detected to verify.

Problems surfaced5 types

Numerical inconsistencies1

Values that contradict each other or are impossible for the stated sample: recomputed p-values and test statistics, GRIM/GRIMMER checks on summary numbers, percentages against their own counts, totals against their parts, and estimates against their own confidence intervals.

Internal contradictions in the reported numbersAssessed

Overstated conclusions3

Conclusions that reach past what the paper's own results support — including a significance claim that no longer holds when the statistic is recomputed, and efficacy resting on an unvalidated surrogate endpoint.

Efficacy rests on an unvalidated surrogate endpointAssessed
Treatment effect not shown to be clinically meaningfulAssessed
Conclusions only partially backed by the presented evidenceAssessed

Reporting gaps1

Required detail the manuscript never states — study design, biological variables, ethics approval and consent, key resources, statistical reporting, data and code availability, and overall transparency.

Data/code availability incompleteAssessed

This Αlpha¹ 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-conducted and transparently reported randomised controlled trial with rigorous design, clear ethical approvals, and appropriate statistical methods. The main weaknesses are the vague data availability statement, lack of code sharing, and minor reporting inconsistencies such as the unstated statistical software and a date discrepancy.

Both reviewers independently scored all eight dimensions and agreed on every status, so no divergence needed reconciliation. The study type is interventional (RCT). Non-applicable sub-criteria (e.g., animal housing, cell lines) were excluded from scoring.

6 major claims checked against the paper's own evidence: 1 only partially supported (evidence backs part of the claim; gaps or caveats remain); the rest adequately supported.

Premise concern: surrogate not validated for clinical benefit; effect size not shown to be clinically meaningful.

Recomputed 2 tests: 2 consistent, 0 inconsistent; 2 via agent-written checks.

1 integrity concern flagged (0 high).

Reporting

Eight Dimensions7 pass · 1 warn

The introduction cites population-based data on recurrence rates and guidelines recommending hormonal treatments, and clearly states the uncertainty about which regimen is better. The rationale for comparing LAPs and COCP is well articulated, and the trial aims to address this gap. Limitations of prior research are implicitly addressed by the trial's design, though not explicitly discussed in the introduction.

Sub-criteria

prior work citedADEQUATE

premise rationaleADEQUATE

limitations addressedINADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

The paper establishes a clear scientific premise with prior work cited and a logical rationale for the trial.

Evidence

paraphrase[Introduction, paragraph 1-2]

“Population based data from Scotland shows that, after initial surgery for endometriosis, 62% of treated women have at least one repeat operation... The UK National Institute for Health and Care Excellence and the European Society of Human Reproduction and Embryology recommend the use of hormonal preparations including the combined oral contraceptive pill (COCP) and progestogens to treat endometriosis related pain.”

direct quote[Introduction, paragraph 3]

“It is unclear as to which of these two treatment regimens is better at preventing the recurrence of endometriosis related pain after surgical treatment.”