The development of modern drugs and their therapeutic use is entirely due to the tireless work of medical researchers. It would be no exaggeration to suggest that the giants upon whose shoulders today's prescribers stand are themselves resting on the bedrock of randomised controlled trials. While some studies have been pivotal in changing the way that medicines are used (e.g. the Medical Research Council trial of treating mild hypertension,1 the Scandinavian Simvastatin Survival Study2 and the United Kingdom Prospective Diabetes Study 343), most trials incrementally add to our knowledge and nudge changes in the way medicine is practised. Despite the …