Automated “smart contracts” that run on blockchain systems could help address ongoing concerns about data transparency, ownership, and integrity in clinical trials. “In the context of clinical trials, SCs [smart contracts] can automate critical processes such as patient matching, consent acquisition, data permissioning, trial monitoring, and stakeholder coordination. Related:Spain continued to lead the EU in clinical trials in 2025, AEMPS reportsTo fully assess the potential of smart contracts, the authors analyzed various studies in which they have been used—everything from academic prototypes to open-source repositories. And, according to the results, smart contracts are being used in a wide variety of trial applications—from patient recruitment, informed consent, and randomization, to adverse event reporting. “The transition to blockchain-enabled clinical trials, if it occurs, will not be a purely technical transformation but a broader organizational and regulatory evolution involving new models of data governance and oversight.”