Education: Ready, Fire, Aim

Example: Ready… Aim… FIRE!
Ready: Formulate the clinical question.
Aim: Design the right sized clinical trial to ensure you have sufficient power to test the hypotheses you are interested in.
FIRE!
 Conduct the trial and report the results with confidence.

Example: Ready… FIRE!… Aim…
Ready: Formulate the clinical question.
FIRE! Conduct the trial as soon as possible, don’t bother with calculating the necessary sample size. Report inconclusive, unclear, underpowered results.
Aim: Figure out the sample size you probably should have used. List the small sample size as a limitation “The small sample size meant we did not have power to detect a significant difference“. Plea for further research on the topic.


Investigators have a responsibility to ensure their trial design and corresponding analysis decisions are sound.

Journals have a responsibility not to publish poorly designed and analysed clinical trials. They should be particularly sensitive to ready, FIRE, aim methodologies (fortunately these are easy to detect).

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