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Why are multi-centre clinical observational studies still so difficult to run?

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Title: Why are multi-centre clinical observational studies still so difficult to run?
Authors: Sandy, J.1, Kilpatrick, N.1, Persson, M.1, Bessel, A.1, Waylen, A.1, Ness, A.1, Ireland, A.1
Source: British Dental Journal. 7/23/2011, Vol. 211 Issue 2, p59-61. 3p. 1 Chart.
Database: Academic Search Ultimate
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  Data: <searchLink fieldCode="JN" term="%22British+Dental+Journal%22">British Dental Journal</searchLink>. 7/23/2011, Vol. 211 Issue 2, p59-61. 3p. 1 Chart.
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        Value: 10.1038/sj.bdj.2011.570
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              Text: 7/23/2011
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