Background
RECRUITMENT
Tension between the priorities of patient care and clinical research has been a central issue in modern medicine since the rise of the clinical trial in the mid-twentieth century [Because they are so thoroughly embedded in practice, pragmatic trials pique the conflict between clinicians’ therapeutic obligation to individual patients and their ability to enroll patients in trials in which treatments are randomly determined and potentially suboptimal [Among trialists, conceptual debates about how to define equipoise tend to be viewed as esoteric [Given its centrality to the problem, there has been surprisingly little work characterizing how clinicians determine whether particular patients are appropriate for trial randomization. A series of studies have examined informed consent conversations, demonstrating how participating physicians’ tendencies to issue recommendations and to use imbalanced language about trial arms can inhibit recruitment [