Thread by @VincentRK

Clinical trials:

See one
Do one
Teach one

Without leading a trial it's hard for you to realize how hard it is to do one and you may end up throwing stones at investigators trying to do their best. #ASH21

See this thread on how many people control the design of a trial. Most of this thread applies also to investigator initiated non randomized trials also. #ASH21

https://twitter.com/vincentrk/status/1230248123148230656

When you have this brilliant idea on how a trial should have been designed, in many cases the PI is also brilliant enough to know the same but they often had to make the hard choice of putting their foot down and not have a trial at all or compromise.
#ASH21

No PI is wealthy enough to find their own trial. No one not even the NCI is willing to give funding for a trial and not get to have their two cents into the design.

No institution is willing to give you open a trial without funds.
#ASH21

Funders always call the shots. If Pharma is running the trial they value your input but ultimately yours is not the only input that matters. They have many considerations.

For investigator initiated trials, you still need funding. Those who fund have review committees. #ASH21

Criticizing a trial is fine. In practice we have to do it to make sure we make the right decisions for our patients.

But when publicly criticizing from the vantage point of an expert, always worth considering: Have I ever led an investigator initiated clinical trial/RCT? #ASH21

Reporters may well do the same in COVID times. Not all experts are experts in clinical trials & don't recognize the trade-offs one has to make, even between speed vs perfection. "Have you ever led a clinical trial" is a good screening question. At least have some balance
#ASH21

*Fund