Randomised controlled trials are the gold standard for evaluating healthcare treatments; 1000s are done every year.



Randomised trials are the cornerstone of evidence-based healthcare because they offer the fairest tests of treatments, therapies and initiatives.



The evidence base for how to make the trials process efficient is remarkably thin. Trial Forge aims to change this.

Small Changes add up

Large, single improvements are nice to have but rather rare.   Marginal gains – small improvements to processes – start to add up if look across a whole system.  Trial Forge aims to look across all trial processes with the intention of trying to improve them all, even if it’s just by a tiny amount, because these gains will start to add up when done across the whole trial system.

Trial Forge will make trials more efficient by looking for marginal gains across all trial processes, from research question to implementation into routine care. It will encourage everyone connected with trials to be more sceptical of what we do by asking for the evidence behind all of our trial decisions.


  • There is a peculiar paradox that exists in trial execution - we perform clinical trials to generate evidence to improve patient outcomes; however, we conduct clinical trials like anecdotal medicine. (Heart Fail Review 2012; 19: 135-52)

    Monica Shah National Heart Blood and Lung Institute, Bethesda, USA.
  • There are a lot of observational studies on recruitment.  Are they useful?  Hard to say, though I aim to find out.  If they turn out to provide little to guide recruitment decisions, we should stop doing them, or they effectively become a recurring example of research waste.

    Heidi Gardner Research Assistant, University of Aberdeen
  • While the research questions and ideas can be novel and ambitious, some of the more challenging questions can often be found in teasing out the methodological issues that surround a clinical trial.

    Dr. Sandra Galvin BSc PhD - Coordinator - Health Research Board - Trials Methodology Research Network
  • In the context of clinical trials, ‘‘quality’’ can be generally defined as the absence of errors that matter to decision-making—that is, errors which have a meaningful impact on the safety of trial participants or the credibility of the results (and thereby the care of future patients).  (Clinical Trials. 2016 Apr 20.)

    Ann Meeker-O’Connell & colleagues Part of the Clinical Trials Transformation Initiative
  • Researchers research so that we as patients and our clinicians can have better conversations

    Derek Stewart Associate Director for Patient & Public Involvement & Engagement with the National Institute for Health Research
  • If research was a transport business, we would be appalled by these data. Half the goods carried would be badly designed, half lost in shipping, and half of the remainder broken by the time they arrived—a truly heart breaking waste.

    Paul Glasziou and Iain Chalmers Lead (PG) and founder member (IC) of the REWARD Alliance
  • Supposing is good, but finding out is better.

    Mark Twain American writer (November 30, 1835 – April 21, 1910)

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