Clinical trials are the cornerstone of current evidence-based medicine. Designs range from effectiveness trials with maximized internal validity but limited external generalizability, to effectiveness and large simple trials that maximize external validity but have reduced precision. Data analytics have equally evolved and become very sophisticated, and it has become increasingly important to choose the most appropriate statistical analysis plan for a given trial design, research question and attempt at minimizing type I and/or type II error. Trial design, conduct and interpretation are critical components that need to be focused on. Both failed and successful trials provide an opportunity for learning.