- One direction is scientific: patient safety, protocol adherence, data integrity, ethical oversight.
- The other is operational and financial: timelines, budgets, contracts, resource utilization, delivery commitments.
These two priorities coexist, but they are rarely managed within a single, coherent structure.
One way to visualize this is as two snakes competing around the same clinical core. One snake pulls toward scientific and patient-safety targets. The other pulls toward financial control and project delivery. Both are legitimate. Problems arise when they are managed in isolation.
Traditional clinical systems tend to reinforce this split. CTMS focuses on milestones and tracking. TMF focuses on documentation. Finance systems focus on cost and revenue. None of them fully represent the clinical trial as an integrated operational entity.
This is where the idea of Clinical Project Management Systems (CPMS) becomes relevant. CPMS concept proposes different framing: treating clinical trials explicitly as projects, with scope, deliverables, acceptance criteria, and traceable evidence of completed work.
In this framing, the “trial” and the “project” stop competing. They collapse into what one might informally call a Clinical Troject! A trial in scientific intent, but a project in how it must be executed, verified, and accounted for.
When this integration is missing, the two snakes keep pulling in opposite directions. When it is present, operational decisions become clearer, documentation regains meaning, and financial recognition aligns more naturally with actual work delivered.
From an operational standpoint, this is not a philosophical debate. It is a question of whether clinical research is managed as fragmented activity or as a coherent, accountable project. Here is more:
Clinical Project Management Systems (CPMS): A Project-Centric Reframing of Trial Operations. Zenodo. https://doi.org/10.5281/zenodo.17924337
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