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Confessions of a chagrined trialist
  1. Steven Goodman
  1. Correspondence to Dr Steven Goodman, Johns Hopkins University, 550 N Broadway, Suite 1103, Baltimore, MD 21205, USA; sgoodman{at}


As a clinical trialist, I had thought that the methods I employed were far more challenging than those I had thought were needed for quality improvement. However, some personal experiences and participation in the Cliveden conference led me to a new appreciation of the methodological and conceptual challenges faced by those trying to improve medical systems.

  • Evidence-based medicine

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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