When (Not) to Stop a Clinical Trial for Benefit

In this issue of JAMA, Montori and colleagues¹ provide a valuable extensive and critical systemic review of clinical trials that were stopped early for benefit. Readers of the reports of such trials often feel a sense of excitement, especially when phrases such as “a major treatment advance,” “ethical need to stop the inferior treatment,” and “vital to tell the world immediately” are used. However, experience suggests that early results and enthusiasm, especially for modestly sized trials terminated early for apparent major benefit, are often moderated as subsequent reports arise.²