A multicenter phase III trial found intravenous tirofiban did not outperform standard oral antiplatelet therapy for 90-day functional outcomes in an acute branch atheromatous disease-related stroke population, challenging the added value of the stronger regimen in this setting. In real-world adoption, a Sutter Health virtual review board enabled community neurologists to prescribe amyloid-targeting Alzheimer’s therapies safely; the program reported 77% of reviewed patients as eligible and ARIA rates below phase 3 trial levels. In cardiometabolic risk, a clinically validated metabolic blood score study reported that lifestyle change improved outcomes for at-risk middle-aged adults, with delay effects on cardiometabolic disease progression tied to the score. Across these reports, the signal is consistent: benefits depend on careful patient selection, measurable endpoints, and real-world governance structures—not just efficacy in controlled trials.