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Why So Many Promising Trials Fail

Most trials fail because the underlying hypothesis is wrong, the dose or timing is off, or the population is diluted. Heterogeneous diseases like heart failure with preserved ejection fraction resisted single targets for decades.

Negative trials still teach: NICE SUGAR reversed glucose dogma, COURAGE and ISCHEMIA reined in stents. Publishing and learning from failure is what separates science from marketing..

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