The project management triangle (Cheap, Fast, Good: Pick Two) takes on a level of complexity in the context of clinical trials. Regulatory compliance, patient safety, and scientific rigor limit the ability to cut corners, making it nearly impossible to sacrifice quality without serious consequences. That often leaves cost and time as the variables.

But here’s the dilemma: Clinical trials are expensive and lengthy by nature. So what happens when sponsors insist on compressing timelines and cutting budgets. We might see compromises manifest in subtle but high-risk ways like underpowered studies, rushed IRB submissions, or inadequate site monitoring. These shortcuts might meet short-term goals but can result in costly errors, protocol deviations, or even trial failure.

Is it possible to optimize all three sides of the triangle in clinical research? Some organizations strategically outsource portions of the trial to Contract Research Organizations (CROs), or adopt advanced digital tools for remote monitoring to reduce overhead and time delays while still maintaining quality and regulatory compliance. But are these truly effective, or just shifting the problem elsewhere. What strategies could be effective to maintain study quality while managing cost and timeline pressures?