How did Worldwide Clinical Trials execute a 12,000-patient mega trial and meet recruitment and study milestones ahead of schedule? Partnership was key, but not just any partnership. When the Worldwide Evidence™ team supported an academic research organization (ARO) on a large cardiovascular outcome trial (CVOT), the project demanded a highly collaborative approach to study execution and third-party engagement. In the following case study, we highlight five lessons that emerged from our successful execution of this study, which involved patients at 476 clinical sites around the world.