On the 6th of February, 2018, the Clinical Trials Transformation Initiative (CTTI), a private-public initiative between Duke University and the US FDA, celebrated its ten-year anniversary. In his keynote speech, Robert Califf, former director of the US FDA argued that the opportunity to connect previously disconnected data systems meant a digital revolution ‘blurring the lines between physical digital and biological spheres’ (Cusher 2018). In the last decade, the randomized control trial, biomedicine’s ‘dominant apparatus of truth making’ (Kaufman 2016:144) has faultered under the complexity of contemporary global monitoring and governance. Against this backdrop, visions for an “in silico” future of research conjure real-time computational global networks, data collection made possible using a myriad of digital technologies and infrastructures. In this presentation, I present some early stage research into contrasting visions of components of the global digital trial, from new softwares for ethics committees to the challenges for regulators faced with new kinds of data. Looking toward research yet to come, can ethnographic research in the space where technologies are designed and deployed ground the speculative nature of digital transformation?