ScienceLife Sciences

Innovating Clinical Trials

Liam Eves and Ted Trafford

Welcome to Innovating Clinical Trials, the podcast designed for clinical research professionals eager to deepen their understanding of clinical trials through concise, insightful segments. Join your hosts, Liam Eves and Ted Trafford, as they uncover the core issues in clinical research, reflect on the industry, and challenge conventional wisdom.

Ted Trafford - https://probitymedical.com/
With 30 years of experience in clinical research, Ted serves as the Director of Business Development, driving business growth and leading Feasibility and Site Relationship teams at Probity Medical Research, a clinical trial site administrative support company with a consortium of 75+ sites across four countries. As a writer and speaker, Ted contributes to thought leadership and strategic initiatives in the clinical trials industry, leveraging his extensive experience and creative approach to drive meaningful discussion and progress for Sponsors, CROs, Sites and Technology Vendors.

Liam Eves - https://www.theendpointpodcast.com/
Liam's held executive roles in SMOs and CROs, and led all major functions of trial delivery. His journey into the field began unexpectedly after an injury ended his career as a professional footballer. Over the years Liam has optimized trial delivery methods / systems for effective enrollment and trial delivery. Currently, he focuses on building and advising companies in the clinical trial space.

Opinions expressed are those of the participants and not their employers.

Play

Open in

26 episodes
Avg 16 min
English

Episodes 26

Newest Oldest Longest

All20 Unplayed20 In progress0 Played0

Counted on this page — what you have heard stays on this device, so it is not something the list can be paged by.

S2 · E32
Today · 19 min
ICT Ep 2.33: Steve Wimmer on the Button That Almost Killed a Recruitment Campaign (Part 3/3)
Each episode in this series has built toward this one: what does all of this look like from the other side of the table? In the final part of this series, the Steve Wimmer shares his experince participating in several clinical trials himself, including one he screen-failed out of, and shares what that experience actually taught him about consent, communication, and being left in the dark. Liam and Ted add their own stories of trying to get into a trial as ordinary, motivated patients and being met with silence from both the sponsor and the site. The conversation closes with one of the most useful stories in the whole series: a call-to-action button on a campaign targeting patients 85 and older that tanked conversion until someone pointed out there was, quite literally, no visible button. Steve leaves listeners with a challenge to the industry's call-and-give-up mentality: with the automation available today, there's no reason to give up on an interested patient just because they didn't pick up the phone the first, second, or fifth time.
S2 · E31
Yesterday · 19 min
ICT Ep 2.32: Steve Wimmer on Why Recruitment Campaigns Fall Apart at the Site (Part 2/3)
Part 1 was about why storytelling matters, part 2 is about how to actually operationalize it and Steve Wimmer brings a framework that reframes the entire recruitment funnel. Every interaction a patient has, from the first ad to the first phone call, is either a trust deposit or a trust withdrawal. Miss that, and the best story in the world won't save a campaign that confuses people the moment they land on a website. Steve Wimmer, Liam Eves, and Ted Trafford move from why storytelling matters to how to actually build a recruitment engine around it. Steve introduces a framework that's worth stealing. He explains why building hundreds of interchangeable creative assets beats chasing one "perfect" ad, and why the hardest part of recruitment isn't generating interest, it's what happens after a lead lands at a site with no clear owner. The episode also includes one of the most concrete stories in the series: an eligibility question that should have disqualified around 20% of a patient population but was disqualifying far more and how Steve's team tackled it and watched the numbers snap back to where they should have been. It's a small story with a big point, most recruitment problems aren't unsolvable, they're just approached differently.
S2 · E31
Tuesday · 19 min
ICT Ep 2.31: Steve Wimmer on Why Storytelling Is What Sponsors Keep Getting Wrong (Part 1/3)
Liam and Ted sit down with Steve Wimmer, who brings seven years of direct-to-patient recruitment advertising experience. They discuss why storytelling in clinical trial recruitment isn't about writing something clever, it's about connecting an ad, a landing page, and a first site visit to something a real person can recognize as their own life The conversation also tackles a myth sponsors carry into every IRB submission: that regulators are the ones saying no. Steve's experience says otherwise and the story of the "silly dinosaur image" that outperformed every carefully considered alternative in the portfolio makes the case better than any deck could.
S2 · E30
August 14 · 13 min
Ep 2.30: Scott Burgher on Where AI Actually Helps Patient Recruitment (Part 3/3)
In the final part of this three-part conversation, Liam and Ted close things out with Scott Burgher, Director of Patient Operations at Quest Diagnostics, looking ahead at where AI genuinely moves the needle in recruitment, and where the industry still gets feasibility wrong. Scott breaks AI's near-term impact into two practical buckets. The first is administrative: compressing study startup from six to twelve months down to weeks by automating document collection, regulatory submissions, IRB correspondence, and budget negotiations, work that's repetitive by nature and ripe for automation. The second is data-driven: using EHR and lab data to flag genuinely qualified patients rather than relying on broad disease prevalence, cutting down what used to take a coordinator six weeks of manual review. They Explore: 1. Where AI can realistically compress study startup timelines, and where it can't 2. Why mining EHR and lab data beats broad disease-prevalence estimates for site and patient feasibility 3. Why the human element becomes the differentiator as software gets commoditized 4. Why most feasibility processes are still solving the wrong problem Scott's closing thoughts on data, predictive medicine, and the road to digital twins. The conversation closes on feasibility, which Scott calls broken at its core, working backward from protocol specifics to find the real "needle in the haystack" instead of the whole haystack. A thoughtful close to the series.
S2 · E29
August 13 · 16 min
Ep 2.29: "That's Not a Performance Problem, It's a Structural One" Scott Burgher on Why Sites Stop Recruiting (Part 2/3)
In Part 2 of this three-part conversation, Liam and Ted continue with Scott Burgher, Director of Patient Operations at Quest Diagnostics, going deeper into why recruitment keeps falling short. Liam reframes the problem from the ground up: the industry treats recruitment as a marketing function obsessed with filling the top of the funnel, when the real work is moving patients all the way through it. Scott connects this to his experience running end-to-end mock trials years ago, testing the full patient journey, not just whether an ad worked, but whether someone could realistically sit through a four-hour infusion or navigate a handoff between site staff who'd never met them. The conversation turns to site economics, which Scott calls structurally broken: sites invest in staff and training months before seeing payment, and when that investment doesn't pay off, they quietly stop prioritizing the study. As Scott puts it, that's not a performance problem, it's a structural one, though it shows up in the data looking exactly like one. Ted pushes the conversation toward what actually closes that gap: a real feedback loop between sponsors and sites, where issues get surfaced, acted on, and communicated back, not just logged and forgotten. A grounded look at what it actually takes to fix recruitment from the inside.
S2 · E28
August 12 · 19 min
Ep 2.28 Scott Burgher on Why 86% of Trials Miss Their Enrollment Deadline (Part 1/3)
In Part 1 of this three-part conversation, Liam and Ted sit down with Scott Burgher, Director of Patient Operations at Quest Diagnostics, who brings over 20 years of patient recruitment experience spanning healthcare marketing, clinical trial agencies, large consulting, and big tech, to talk about the good, the bad, and the ugly of patient recruitment. In this episode, Scott breaks down why recruitment keeps missing the mark. He argues that sponsor decision-making cycles are a massively underestimated blocker, a recruitment strategy can be fully approved by the study team and still sit untouched in legal or procurement for months while the clinical timeline keeps ticking, often defaulting back to digital and social media ads as a last resort. Liam connects this to a separate problem he's seen across budgets: an "iceberg" of recruitment costs sitting below the surface, the centralized strategy and patient-processing work that rarely gets line-itemed alongside site costs. They Explore: 1. Why the 86% missed-enrollment-deadline statistic hasn't moved in over a decade, even as industry awareness has grown 2. How sponsor decision-making cycles quietly stall recruitment strategy for months before outreach even begins 3. The "iceberg" problem: recruitment costs that never make it into the visible budget 4. Why most patients never hear their doctor recommend a clinical trial, and what that gap costs 5. Where AI is genuinely useful in patient identification, and where it's being oversold as a fix 6. The role of primary care physicians in patient recruitment A candid look at the structural issues behind patient recruitment.
S2 · E30
July 22 · 15 min
Ep 2.27: 31 Years of Clinical Trials, Here's What Ted Trafford Knows for Sure
In this special episode, we mark Ted Trafford's 31st year in clinical trials with a candid reflection on what three decades in this industry actually teaches you. It started with a LinkedIn post Ted wrote where is says that after 31 years, he said he'd learned nothing. Listen in to hear what he meant by this. Liam and Ted go on to discuss the more experience you accumulate, the more you realise how much you still don't know. Liam frames this through the circle of competence: as your knowledge grows, so does your awareness of everything sitting outside it. Thirty-one years in, Ted feels that more than ever, and both hosts agree that the willingness to say "I don't know, can you explain that to me" is what separates people who keep growing from people who stop. The conversation also turns to recruitment, where Ted has been quietly building a list of every factor that affects clinical trial enrollment. One item on that list stands out: story. Most sponsors, Ted argues, don't have a compelling narrative around their molecule or their trial, and that gap costs them more than they realise. Liam connects this to something much older than clinical research. Humans have always been moved by story before they're moved by data. This episode is a grounded, honest conversation about what it means to spend a career in this industry, and still be learning.
S2 · E29
July 10 · 18 min
Ep 2.26: Lasagna's Law and Building Recruitment Forecasts You Can Actually Trust
Every trial starts with a number on a slide, patients needed, months allotted, a clean straight line on a chart. Liam and Ted pull that line apart in this episode, starting with Lasagna's Law: the 1970s observation that eligible patients seem to vanish the moment a trial opens and reappear the moment it closes. They dig into why recruitment forecasts go wrong not because the math is bad, but because the assumptions underneath the math are never tested, tracked, or even written down. Liam reframes recruitment forecasting using a sat-nav analogy: the plan is your estimated arrival time, the forecast is what updates as you actually drive. Ted brings a wildlife photographer's lens, literally, arguing most sponsors are zoomed in on the wrong details and missing the bigger picture entirely. A grounded, practical conversation for anyone responsible for building a forecast around best-case, worst-case, and base-case scenarios instead of one optimistic line.
S2 · E25
June 17 · 15 min
Ep. 2.25 The Burdens Still Breaking Clinical Trials: 50-Page Consents, Broken Tech, and Stolen CRCs
In this episode, Ted opens with a poem that captures the persistent, compounding burden on clinical trial sites: 50-page consents, non-functional tech, poached CRCs, financial holdbacks, and study designs that ask far too much from participants for far too little payoff. What follows is a candid conversation between Ted and Liam about why these problems haven't gone away and in many cases, have gotten worse. Study visits in 2026 take twice as long as a decade ago. One in three procedures collected don't support a primary or key secondary endpoint. Endpoints, procedures, and planned visits have each grown by roughly 40% over 15 years. But this episode isn't only a critique. Conversations with small biotech, mid-size sponsors, and a large pharma groups, all reached out to ask what sites actually need and what's getting in the way. Thirty years ago, that didn't happen. There is a shift and that's worth paying attention to.
S2 · E24
June 10 · 21 min
Ep 2.24 The Decision Threshold Matrix: Why Patient Motivation Isn't Fixed and What It Means for Trial Recruitment
In this episode, Liam and Ted explore one of the most underexamined problems in clinical trial recruitment: patient motivation is not static. Drawing on real-world experience from a late-night participant funnel audit to an insomnia study no-show Liam introduces two interconnected frameworks: the Decision Threshold Matrix and the Trial Value Equation. The matrix maps patient motivation across four quadrants defined by disease severity and perceived treatment adequacy. It breaks down how patients unconsciously calculate whether participation is worth it and why trial teams consistently inflate the denominator (burden) without strengthening the numerator (benefit). Together, these tools offer a behavioral science-grounded lens for understanding when, why, and how patients engage with research and what teams can do about it. This episode is for anyone working in patient recruitment, site management, or protocol design.
S2 · E23
May 21 · 13 min
Ep 2.23: Jill Fikowski on Why Participants Drop Out and What to Do About It (3/3)
In the final episode of our three-part series with Jill Fikowski, founder and CEO of Changemark Research + Evaluation, we get into one of the most persistent problems in clinical research: retention. Jill unpacks why participants drop out and it's rarely what sponsors assume. From there, we get into the pressure that lands on research coordinators when enrollment is behind, the practices that pressure produces. We also look at what happens after the last visit particularly in psychedelic trials and whether researchers have a responsibility that doesn't end when the database closes. Retention problems, Jill argues, are almost always inception problems. And solving them starts with a question most teams never ask. Part 3 of 3.
S2 · E22
May 20 · 21 min
Ep 2.22: Jill Fikowski on Designing Trials That Communities Actually Want to Join (2/3)
In Part 2 of our conversation with Jill Fikowski, founder and CEO of Changemark Research + Evaluation, we get into what good community engagement actually looks like in practice not as a checkbox, but as a core design principle. Jill opens with a clear answer to what good looks like: involve community from the very beginning and not just at the consent stage, not just in an advisory board email, but in protocol design, recruitment strategy, and how findings are shared. Jill walks us through a Quebec youth cannabis and psychosis study that surpassed both its enrollment and retention targets simply by asking participants what they needed before the protocol was finalised. We also get into the tension between industry-sponsored research and genuine community care. Part 2 or 3
S2 · E21
May 19 · 13 min
Ep 2.21: Jill Fikowski on on Substance Use, Stigma, and the Research That Actually Changed Policy (1/3)
Jill Fikowski, founder and CEO of Changemark Research + Evaluation, brings 25+ years of lived and professional experience in substance use and mental health research. In this episode we cover her work on the SALOME trial, one of the rare studies that directly changed policy. But it wasn't just the science. It was how they centered participants from the beginning. We also explore: 1. How to design community engagement and knowledge translation into your trial from day one 2. The gap between saying participants matter and actually building research around their humanity 3. What happens when you ask participants at the end: "What could we have done better?" 4. The difference between checking the box on community input and genuinely centering stakeholder voices She challenges us to confront how our biases shape every decision: who we enroll, what data we collect, what we do with findings, and whether we ever ask participants what they actually needed. Part 1 of 3.
S2 · E20
May 14 · 12 min
ICT Ep 2.20: What Monty Python Can Teach Us About Clinical Trials
Clinical trials don’t become complex overnight, they get there one added process at a time. In this episode, Ted and Liam break down why the industry is so effective at adding new layers, but rarely takes the time to remove what’s no longer needed. Whether it’s protocols, systems, or workflows, each addition is often made with good intent, but the cumulative effect can be significant. They explore how this impacts sites in particular, increasing workload, creating friction, and ultimately making studies harder to execute. The discussion also highlights how relying on historical processes and “what’s worked before” can prevent teams from adapting to today’s reality. Most importantly, they challenge listeners to rethink how processes are designed, not just by optimising what exists, but by asking whether it should exist at all. A practical and thought-provoking conversation on reducing complexity and improving trial execution.
S2 · E19
May 6 · 12 min
ICT Ep 2.19: Everyone Has a Plan Until the Trial Starts
A 5 AM wake-up call. A perfectly planned setup. And a moment that never delivered. In this episode, Liam and Ted use a story about a missed “blood moon” to explore a deeper truth in clinical trials: expectations don’t always match reality. They discuss how similar frustrations show up at clinical trial sites, where small issues stack up and slowly erode motivation. They break down how friction at the site level, long trainings, broken systems, and unclear processes, gradually drains momentum. From pre-mortems to escalation paths, this conversation focuses on how to prepare for what will go wrong, even before it does.
S2 · E18
April 29 · 13 min
ICT Ep 2.18 What Recruitment Is Missing: Time, Trust, and a Cup of Tea
What does it actually mean to put the patient first? In this episode, Liam and Ted explore the role of empathy and human connection in clinical trials. From rushed pre-screening calls to a powerful story of pausing a consent conversation just to connect, they highlight how small moments build lasting trust. They also discuss why trust is rarely factored into budgets, despite being critical to recruitment, retention, and patient experience. A thoughtful conversation on why clinical research needs to see the person behind the data.
S2 · E17
April 16 · 14 min
ICT Ep 2.17 Borrowing the F1 Playbook: What Formula One Gets Right That Clinical Trials Don't
What makes a truly high-performing team? Inspired by the precision of Formula One pit crews, where the difference between winning and losing is measured in milliseconds, Ted and Liam explore what clinical trial teams can learn from elite performance environments. Ted outlines six principles that drive high-performing teams: clear objectives, defined roles, mapped processes, and a culture of continuous improvement. Liam draws on his experience in professional sport to reflect on why teams that truly operate at that level are rarer than we think, and why clinical trials are no exception. The episode leaves listeners with one question: what if we did the debrief before the problem existed?
S2 · E16
April 13 · 13 min
ICT Ep. 2.16 Leading Teams That Take Risks and Deliver Results With Frank Watanabe (3/3)
In Part 3 of 3, Liam and Ted continue their conversation with Frank Watanabe, CEO of Arcutis Biotherapeutics discussing work-life balance, building social capital, and management vs. leadership. The conversation explores leadership at a practical level, from building trust across remote teams to creating flexibility that allows individuals to balance work and life in a way that works for them. Finally, he outlines his vision for Arcutis and what “meaningful innovation” really means focusing on solving real problems that matter to patients and clinicians.
S2 · E15
April 9 · 11 min
ICT Ep. 2.15 Innovation, Risk and Building Great Teams With Frank Watanabe (2/3)
In Part 2 of 3, Liam and Ted continue their conversation with Frank Watanabe, CEO of Arcutis Biotherapeutics, focusing on what it takes to hire and build high-performing teams in high-risk environments. Frank shares how he approaches hiring beyond technical skills placing strong emphasis on cultural fit, risk tolerance, and the ability to innovate. The discussion also explores how to create a culture where people feel comfortable taking risks and learning from failure. From encouraging teams to challenge the status quo to fostering psychological safety through leadership, Frank outlines what it takes to build organizations that continuously improve. They also dive into aligning incentives, building a mission-driven culture, and ensuring that when a company succeeds, its people succeed too.
S2 · E14
April 7 · 15 min
ICT Ep. 2.14 From Navy Officer to CEO: The DNA of Leadership with Frank Watanabe (1/3)
In this episode, Liam and Ted sit down with Frank Watanabe, President and CEO of Arcutis Biotherapeutics, to explore his journey from a Navy officer to a biotech executive and the leadership principles established along the way. Frank shares how his early experiences in the military and his transition into pharma and biotech influenced his approach to leadership, highlighting a key idea that defines his philosophy: leadership isn’t about authority, it’s about earning trust and loyalty. They discuss how operating principles can become the “DNA” of a company, not just words on a wall, and what it takes to embed culture into everyday decision-making.

Showing 1–20 of 26 episodes