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Priority, prediction and the ethical research enterprise
  1. Spencer Phillips Hey1,2
  1. 1Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
  2. 2Center for Bioethics, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Spencer Phillips Hey, Center for Bioethics, Harvard Medical School, 641 Huntington Ave., Boston, MA 02115, USA; shey{at}

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In their essay, ‘When Clinical Trials Compete: Prioritizing Study Recruitment’, Gelinas et al describe a collective action problem that can arise if multiple trials at a single institution are all trying to recruit participants from the same patient population. Each trial may be addressing an important question, and each will need a certain number of participants to provide an informative answer (or to maximise the likelihood of producing an informative result). But because these trials are all recruiting from the same population, it is possible that there will not be enough participants to go around. It may turn out, then, that none successfully achieves its target sample size and all end up being uninformative or less informative than hoped.

As Gelinas et al observe, these kinds of uninformative or less-informative trials are ethically problematic, since they fail to fully redeem participant risks and burdens with adequate gains in generalisable knowledge. Such trials also represent wasteful or inefficient research activities, since each necessarily has a human and material cost, but then fails to offset these costs by providing a definitive answer to the research …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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