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Dawson L et al. – The goal should be that each trial will contribute to the accumulation of knowledge via a sequence of investigations, which together lead to a causally coherent understanding of treatment effects. So an investigator must be able to look beyond the trial in question and explain how its results will inform future research that lead to such an understanding. Studies implementing “usual care” arms can complicate this task, but if done right can ultimately lead to results of great scientific relevance and practical value.

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