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Thank you authors and the faculty and residents from UChicago for a great discussion so far! Earlier in the discussion it was mentioned that with the number of drugs available out there, it's challenging to study all the different combinations. In the oncology-sphere, there is a similar challenge, and trialists have adopted multi-arm designs that adapt at interim analyses with selective dropping out of arms due to futility or efficacy. Cardiology has so far done well with classic trial designs and stuck to them. What do the authors see as barriers and differences between the fields for not using more sophisticated trial designs to do more with fewer patients?