During the course of clinical practice, physicians and surgeons may deviate from standard therapies and techniques, in the hope of providing the best care for their patient. This new approach may not fit the definition of current standard care; but its goals (individual patient care) and its conduct (without the indicia of a randomized clinical trial) may also not quite fit the model of research. With the sharing of information about these innovative experiences, the ability to classify novel approaches may become challenging. As it is not always clear whether clinical and/or research...