In keeping with my commitment to ask “Why?,” I have been thinking about the word “pulse.” Do we really need to take the pulse of multinational studies in order to prove they are still vital? Maybe we mean to use the information we gather by taking the pulse of these studies to diagnose the health of our industry. Why does a research center in Billings, Mont., need to know the pulse of what is happening at a center in Kyoto, Japan? Is this merely a habit born from Good Clinical Practice, like taking a patient’s weight at each office visit? How does examining the rhythmic throbbing of every research study become a benchmark for understanding the ideal metrics of each new clinical trial?