I know some have become experts at clinical appraisal and clinical trial critique. It’s important to have this dialogue and it helps physicians and patients understand the drawbacks of a given trial. But my advise to young investigators is to best not to make it your primary academic output. Secondly, when critiquing it’s also worthwhile remembering that the investigators of trials may also fully aware of the issues but there are many barriers and often we have to choose between not doing a trial at all versus compromising. Perfect trials are not common; we can usually find some fault with almost all trials. So we must strive to avoid rudeness and condescension. Third, try if possible to lead a clinical trial or at least get engaged with someone who leads trials and get a feel for the various stakeholders who have veto power during trial design, and more importantly the various competing priorities for what the trial seeks to accomplish, it will be easier to understand why a specific control arm was chosen, or a why a specific endpoint was chosen, even though you may think they are the wrong ones.