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All clinical trial investigators have ethical and regulatory obligations to monitor participant safety and trial integrity. Specific procedures for meeting these obligations, however, may differ substantially between pragmatic trials and traditional explanatory clinical trials. Appropriate monitoring of clinical trials typically includes assessing rate of recruitment or enrollment; monitoring safe and effective delivery of study treatments; assuring that study staff act to minimize risks;doi:10.1186/s13063-019-3869-3 pmid:31815644 pmcid:PMC6902512 fatcat:5kfzvrtklfgndlytf3dqufrdia