Abstract
<jats:p>Clinical trials occupy a central position in modern medicine because they generate evidence used to decide whether interventions are effective, safe, and worth implementing. Their social value depends not only on scientific ambition but also on integrity: the assurance that trials are ethically justified, methodologically sound, operationally controlled, statistically credible, transparently reported, and open to scrutiny. Clinical trial integrity is broader than fraud prevention and broader than regulatory compliance. It includes the relevance of the research question, the protection of participants, the precision with which the treatment effect is defined, the faithful execution of the protocol, reliable data governance, prespecified statistical analysis, balanced interpretation, and responsible public communication. This article argues that trial integrity is best understood as a life-cycle concept. It begins with a clinically meaningful question and a design capable of answering it, continues through trial conduct, data management, statistical analysis, interpretation, and transparent reporting, and extends after publication through data sharing, public audit, post-publication review, and correction of the scientific record. Particular attention is given to prespecification, trial registration, statistical analysis plans, the query process, negative trials, early termination, and the interaction between personal, institutional, and community-driven integrity. The central claim is that trustworthy clinical trials require more than procedural compliance. They require a professional culture in which patient welfare, methodological rigor, reproducibility, and public accountability remain aligned throughout the entire trial life cycle.</jats:p>