I had an occasion to deep dive into hundreds of clinical trials about a year ago, talk to PIs and trial participants, etc. One thing I didn't even have awarene

I had an occasion to deep dive into hundreds of clinical trials about a year ago, talk to PIs and trial participants, etc. One thing I didn't even have awareness of, let alone appreciation for, was how essential it is to have a good trial design (or maybe how an insufficiently considered trial design can be vulnerable to catastrophic failure modes). It seems that running these 'small batch' studies/trials can be tremendously helpful to inform and refine the approach before executing on a larger scale. Of course if it takes 3 years to reach an endpoint it probably doesn't make sense to serialize them, but to my layman perspective there appears to be clear value (and in this case encouraging results).