What Digital Technologies are Being Used to Enhance Clinical Trial Enrollment and Diversity?

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The authors of a recent study published in Sage Journals conducted a cross-disciplinary review of 614 articles to identify different types of digital technologies currently being used in clinical trials. The review had two key goals: (1) identify and describe the digital technologies applied in clinical trial recruitment and enrollment and (2) evaluate evidence of these technologies addressing the recruitment and enrollment of racial and ethnic minority groups.¹

“Many clinical trials fail because of poor recruitment and enrollment which can directly impact the success of biomedical and clinical research outcomes,” the study authors wrote. “Options to leverage digital technology for improving clinical trial management are expansive, with potential benefits for improving access to clinical trials, encouraging trial diversity and inclusion, and potential cost-savings through enhanced efficiency.”

The articles rreviewed were published in PubMed, IEEE Xplore, and ACM Digital Library between January 2012 and July 2022. MeSH terms and keywords for digital health, clinical trials, recruitment, and enrollment were utilized to identify relevant information in the articles. While 614 articles were identified following the initial review, the final number deemed relevant to the study objectives was 21.

Results of the study identified various commonly used digital technologies. The most prevalent included: multimedia presentations (19%), mobile applications (14%), social media platforms (29%), machine learning and computer algorithms (19%), e-consenting (24%), blockchain (5%), web-based programs (24%), and virtual messaging (24%).

“Social media, virtual messaging, web-based platforms, and machine learning/electronic health record (EHR) were the most frequently discussed and evaluated digital technologies, while multimedia, mobile applications and blockchain were less frequently explored or formally evaluated,” the authors added.

Of the most prevalent technologies identified, multimedia presentations were mentioned across several of the reviewed articles. These presentations were most notably utilized during the recruitment and consenting phases of clinical trials. The articles that mentioned these presentations found that participants were able to better understand the trial’s protocol with video consent because they could watch at their own pace. Interactive multimedia technology was also shown to be beneficial in learning.

“Several articles discussed the use of digital technology to enable online users to join communities by sharing their clinical trial experiences in forums,” the authors wrote. “However, a related key barrier to clinical trial enrollment in the context of knowledge and information seeking was a lack of overall public awareness about clinical trials.”

While the study was able to identify support for the potential use of some of these digital technologies to increase the effectiveness of recruitment and enrollment, the authors noted that research is still emerging. Many of the articles supported usage in the form of commentary rather than empirical data.

Looking forward, the authors identified that additional research, industry commitment, and regulatory guidance are needed across multiple disease types and digital technologies to determine the best approach in utilizing them. They highlighted promoting trial diversity, cost efficiency, and throughput as goals that should be considered.

“Further, there is little evidence suggesting the purposeful use of these digital technologies to enhance shared health equity goals, specifically for addressing needed improved enrollment and recruitment of racial and ethnic minorities and other difficult-to-reach populations,” the authors concluded. “Additional research, industry commitment, and regulatory guidance are needed across multiple disease types and various digital technologies to determine the best approaches for leveraging these technologies to promote trial diversity and equity, lower costs, improve throughput, and reach enrollment goals.”

Reference

1. Kasahara A, Mitchell J, Yang J, Cuomo RE, McMann TJ, Mackey TK. Digital technologies used in clinical trial recruitment and enrollment including application to trial diversity and inclusion: A systematic review. DIGITAL HEALTH. 2024;10. doi:10.1177/20552076241242390