Logistics of large international trials: the good, the bad, and the ugly.

The pace of development in intensive care medicine seems to be increasing all the time. Nowhere is that more apparent than in the field of clinical trials. Large international multicenter studies are increasingly being used to evaluate new interventions and to provide epidemiologic data. Such studies promise fast results with good generalizability, but the limitations of these trials should not be forgotten in our search for a speedy conclusion. In this article we will discuss the good, the bad, and the potentially ugly side of international clinical trials in intensive care.