Getting control rates right before randomization

How are you deriving baseline event rates when recent EHR coding shifts skew historical comparators? In a sepsis RCT last year, we powered for 30% 28-day mortality but observed 18% in control; I’m weighing a brief pre-randomization calibration cohort versus blinded sample size re-estimation at 100 patients to maintain type I error without inflating N — what has worked for you?

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