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In clinical research settings, “vulnerable populations” refer to groups of people who can be harmed, manipulated, coerced, or deceived by unscrupulous researchers because of their limited decision-making ability, lack of power, or disadvantaged status. However, individuals from these populations may legitimately participate in clinical trials under ethical and well-managed conditions,

While the “do more with less” mantra probably dates back to some well-meaning prehistoric manager from the dawn of organized labor, its modern prevalence in clinical research settings can seem particularly galling in the face of serious fiscal uncertainties and ongoing workforce supply and readiness challenges when patients’ lives and wellbeing are on the line. 

Alan Kivitz, MD, MACR, CPI, President and Founder of the Altoona Arthritis & Osteoporosis Center in 1982 and the Altoona Center for Clinical Research in 1992, was recognized among many others during ACRP 2025 for achieving remarkable longevity in their certification journeys. As a Certified Principal Investigator (CPI®) in Pennsylvania since 2004, he has seen a lot of evolution in the world of clinical research, and we are happy to share some of his experience and insight with our readers here. 

Clinical research sites are at a transformative juncture, facing heightened demands to deliver trials with greater speed, efficiency, and quality than ever before. As the industry embraces rapid innovation, digital transformation, and more complex protocols, pressures are intensifying at the site level, where budget constraints, funding cuts, and operational demands continue to grow. Today’s research sites must navigate a multifaceted landscape, contending with fragmented communications, persistent technology changes, and the need to recruit and retain skilled talent, among other obstacles.   

Clinical research participants should reflect the disease population in question. This statement is a no-brainer; however, drug and device developers and clinical trials teams have failed countless times at accomplishing this task.