We’ve all heard the maxim that “bigger is not better,” but who is really paying attention to it in the clinical research enterprise? One expert observer who will speak at ACRP 2027 in San Diego says that, as clinical research site networks expand through acquisitions, partnerships, new site activations, and geographic growth, the challenge extends beyond increasing the number of locations. She notes that, particularly for advanced and complex therapies, sustainable expansion requires operational infrastructure, governance, and site readiness to keep pace with network growth.

In her upcoming presentation for ACRP 2027 in San Diego, Sahar Zahid, MD, will examine the “butterfly effect” of such actions as a single copy-and-paste from a source document into an AI tool by one professional potentially having repercussions downwind for participant privacy, sponsor confidentiality, contractual obligations, institutional policy, vendor governance, data security, study integrity, and organizational trust.

Most research organizations have no shortage of performance metrics. Enrollment rates, activation timelines, participant retention, protocol deviations, and financial measures all provide valuable insight into how research programs are performing. Yet these measures do not always answer a fundamental question, understanding not all trials require the same effort to achieve the same result?: What did it actually cost to achieve those results?