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Clinical Trial Automation: The Naming Conventions Challenge

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Is cross-system clinical trial automation failing not because workflows cannot be executed, but because protocol terminology cannot be interpreted consistently across systems and clinical studies? Discussions about automating clinical trials often focus on advanced technologies such as workflow engines, interoperability standards, and AI/ML. In practice, cross-system automation most often breaks much earlier, at a far more basic level: inconsistent naming conventions .  Clinical protocols are written in natural language, where the same term can legitimately carry different meanings depending on study design, therapeutic area, or regulatory intent. Software systems, by contrast, assume that identifiers are stable, explicit, and unambiguous. This mismatch creates friction long before questions of execution logic or governance arise. Several academic and industry initiatives have proposed encoding protocol elements, such as eligibility criteria, visits, milestones, consen...