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At the outset, I would like to congratulate the authors and BMJ for an excellent article. There is tremendous importance in medical literature given to the ways of handling dropout in all types of prospective studies. There is a need for equal or increased emphasis on planning for minimal dropout at the design stage of the study. Probably only in case of RCTs planned in the field of anesthesia, there will not be any dropout. A continuous informed consent process, enroll greater number of potential participants, training of clinical trial personnel, appropriate selection of trial sites are some of the important issues which need to be addressed.