Members of a clinical trial expert group have come together to provide a call for action to reinvent randomised clinical trials to be fit for purpose. Representing the European Society of Cardiology (ESC), American Heart Association (AHA), World Heart Foundation (WHF) and American College of Cardiology (SCC), this joint opinion recognised the opportunity for global impact, including streamlining the trial processes by using routine data and adopting revised guidelines from the ‘Good Clinical Trials Collaborative’ (GCTS https://www.goodtrials.org/) To access the paper for more information, https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehac633/6886997