Definitive randomized controlled trials (RCTs) are the cornerstone of evidence-based medicine but can be complicated, protracted, and expensive. Given the challenges of large-scale trials, pilot trials serve as a crucial initial step, allowing for refinement and validation before embarking on the definitive RCT.1 They are a crucial element of good study design and, while conducting a pilot RCT does not guarantee success of the definitive RCT, it increases the likelihood of successful trial completion.2 More than US$100 billion is invested annually in biomedical research but often this research is conducted wastefully from poor study design and/or study procedures.3 Conducting a well-designed pilot RCT before launching an expensive, time-consuming definitive trial can minimize research waste and improve study conduct. ; Full Text