The Good Enough Trial

There are outstanding, good enough, and poor trials. The outstanding trial is characterized by having the highest scientific and ethical quality. These are the types of trials we want to have as many of as possible. The poor trial, on the other hand, is characterized by not sufficiently meeting current scientific and/or ethical standards. We want as few of these as possible. Somewhere between these two extremes lies the good enough trial.

What is Good Enough?

The art lies in being able to distinguish between them in practice. A study does not need to be outstanding to receive a positive assessment, approval, or statement from a scientific ethics committee. However, there is also a lower limit to how poor the quality and ethics of a project can be to receive a positive evaluation. This concern is not only for the participants in the trial but also for the broader population that, for example, might risk being treated with medication for which there is insufficient evidence. Moreover, it is crucial for scientific development that research involving humans generally enjoys trust and support from the broader population, which requires maintaining a certain level of scientific and ethical standards.

Scientific Quality

There are several approaches one can take to the question of when a study is good enough to receive a positive assessment or statement. Regarding the scientific quality of the study, one could, for instance, rely on a set of more or less objective thresholds for the overall uncertainties associated with the study's conclusions. This approach is familiar in the context of power calculations and sensitivity analyses. Similarly, one can consider the overall uncertainties of a research project's results and from there assess whether the experiment is scientifically good enough to proceed.

One could also consider the existing knowledge in the field. If there is relatively little knowledge already available in the field, it could argue that a trial is scientifically good enough to proceed, even if it can only contribute with relatively sparse or somewhat uncertain knowledge. This approach is more flexible than the aforementioned but simultaneously risks setting the bar too low.

Ethical Quality

When it comes to the ethical quality of a study, it's beneficial to consider the aforementioned distinction between what is ethically permitted, required, prohibited, and supererogatory. In the good enough trial, one stays within the bounds of what is ethically allowed, actively does what is required, and refrains from what is ethically forbidden. However, one does not necessarily do more than what duty demands. Unlike the outstanding trial, the good enough trial does not go beyond the minimum requirements from an ethical perspective.

Overall, one can say that the good enough trial sufficiently improves our position from both a scientific and ethical perspective compared to where we would have been otherwise by delivering sufficiently reliable, precise, and generalizable results without compromising significant ethical considerations and principles. This doesn't mean one can't encourage applicants to aim higher when possible, but the primary task is to differentiate poor scientific projects from those that are reasonably good enough.