Dr Michael Fehlings, Professor of Neurosurgery at the University of Toronto, draws on his extensive clinical trial experience, to share what he thinks ensures success; from the design, to the conduct and its implementation. This is part of a special 'Research Top Tips' series, from Myelopathy Matters (Myelopathy.org) and AO Spine RECODE-DCM, as they work together to accelerate knowledge discovery that can change outcomes in DCM.