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Documentation

Introduction

The Importance of Clinical Trials


Clinical trials are the vital step that helps scientists build a ladder to medical success. Participants are an inseparable part of the recruiting process. Unfortunately, finding eligible and motivated participants is one of the major challenges that experts face (Topolovec-Vranic et al., 2016). In fact, approximately 80% of studies experience delays due to recruitment issues. Delays cost more than $2 billion each year (“A paradigm shift in patient recruitment for clinical trials,” 2017).

The importance of clinical trials is not only a research problem. Delays in clinical trials lead to real negative outcomes for patients as they often rely on medical findings and new medications. So how can clinical trials lead to practical success and positive outcomes for patients?

 

Digital Recruitment & Clinical Trials


Today’s technology-driven society has changed dramatically. Online shopping, virtual counseling, and remote work: technology has an impact on all aspects of life. Medicine is not an exception. Therefore, it’s not surprising that digital recruitment is on the rise.

Due to the complexity of all research requirements, conventional methods (such as community outreach, radio advertisement, and boards in clinics) are becoming ineffective. What’s more, data show that patient screening success has dropped significantly in recent years. On top of that, ethical principles put additional restraints on research and clinical trials, which narrows the patient pool.

In fact, there’s over 150% increase in eligibility criteria; and a survey conducted by the Clinical Trials Transformation Initiative (CTTI) showed that the most difficult obstacle to overcome is identifying patients who meet the eligibility criteria (“A paradigm shift in patient recruitment for clinical trials,” 2017).

Last but not the least, figures can blow your mind: although companies worldwide continue to spend more on recruitment each year, 46% of trials fail due to poor recruitment.

Although numbers speak for themselves, researchers keep wasting huge portions of their limited budget on recruiting via standard methods (such as fliers and TV ads). On the other hand, the expenditure on the Internet for digital recruiting is too little:

 

At the same time, studies that compare conventional methods and digital recruitment practices show that digital recruitment ‘beats’ conventional methods. There are three categories that prove that: effectiveness, cooperativeness, and cost-effectiveness (Topolovec-Vranic, 2016). Effectiveness refers to the number of participants in each study, cooperativeness can be described as the diverse range of demographics, and cost-effectiveness is related to the total cost of the recruiting campaign.

If 46% of trials based on conventional recruitment fail, and only 1% of the budget is spent on Internet recruitment? Why is this discrepancy and how can digital recruitment become an established practice in medicine?

 

Why Digital Recruitment?

There are numerous reasons to choose digital recruitment. Ready to give it a go?

Make It Easy

First of all, digital recruitment is relatively easy; mainly because research becomes more patient-friendly. By including mobile technology and accessible e-tools, researchers eliminate many obstacles to participation, such as complicated technology, time-consuming training, cognitive burden, and long commuting.

Medical professionals also benefit from digital recruiting. By using reliable technology and online data, experts have the unique chance to analyze relevant information and apply findings to medical treatment in real-time.

Go Online

As mentioned above, another advantage of digital recruitment consists in the fact that this method eliminates commuting. As clinical trials require numerous testing and constant observation, commuting can be a challenge even for interested and engaged participants. In fact, people who live in smaller regional centers are more likely to enroll and complete a trial than people in huge cosmopolitan cities (Nash et al., 2017). Simply because they don’t have to commute for hours!

For instance, NIH PROMIS, one of the powerful Qolty modules, give participants the unique opportunity to provide subjective data, such as cravings, at all times. Using a mobile device and engaging apps is beneficial for both participants and researchers.

No Boundaries

Digital recruitment helps you expand your horizon. It eliminates a major burden that might narrow the patient pool: the location of participants. Participants are only a click away, and on-site recruitment is not needed. In addition, researchers can target hard-to-reach subjects. In fact, digital recruitment benefits a huge number of studies that require hard-to-reach participants (Topolovec-Vranic, 2016). Also, by choosing different eligibility criteria, researchers can make their search more specific and colorful at the same time. Ethnic minorities, transgender people, cancer patients: researchers can target numerous hard-to-reach subjects and enrich their research (Admon et al., 2016).

Although numbers speak for themselves, researchers keep wasting huge portions of their limited budget on recruiting via standard methods (such as fliers and TV ads). On the other hand, the expenditure on the Internet for digital recruiting is too little:

  

Digital recruitment facilitates the inclusion process, while researchers have more control over advertisement costs and duration. For instance, Facebook campaigns – a major part of digital recruiting – are easy to manage, engaging, and cost-effective.

 

Easy to Manage

As mentioned above, researchers can strengthen their inclusion criteria and experience control over the advertising methods used in their study. Digital recruitment helps researchers access and manage data at all times, in real-time. On top of that, digital recruitment may foster meta-analysis and collaboration between different institutions and separate studies.

At the same time, the collected sensitive information can be stored safely in the cloud. Consent forms and various access options guarantee safety. Usually, when it comes to collecting information via conventional methods, clinical staff is required to collect and analyze data (especially for rare diseases). Note that such staffing can reach 40-45% of the budget (“A paradigm shift in patient recruitment for clinical trials,” 2017). Thus, digital recruitment eliminates all these issues and makes data collection easy, efficient, and safe.

 

No Errors

In other words, digital recruitment facilitates the recruitment process and data collection. In general, standard strategies often include a search for medical data, which is stored in Electronic Medical Records (EMRs). However, searching for structured data is time-consuming and requires personnel training. In fact, more than 30% of patients reviewed for a trial require more than 30 minutes of analysis and review.

All that makes recruitment prone to human errors. Sometimes automated data extraction is possible, but that often leads to missed opportunities (“A paradigm shift in patient recruitment for clinical trials,” 2017). Nevertheless, digital recruitment and CTMS with their numerous inter-operability options help researchers collect and manage data eliminating possible errors.

 

Cost-effective

What’s more, digital recruiting is cost-effective. Clinical trials are one of the most expensive phases of each medical study. Usually, recruitment costs take up to one-third of the whole budget for each clinical trial. In fact, data shows that between 2008 and 2013, phase I trial costs have risen by 157%, while phase II trial costs – by 108%. Digital recruitment proves to be more cost-effective than clinic-based recruitment (Admon et al., 2016).

Clinical trials shape the future of many pharmaceutical giants. That’s right – clinical trial costs affect businesses. Data shows that if researchers manage to shorten the study process, every month would be worth $25 million in revenue for sponsors (“A paradigm shift in patient recruitment for clinical trials,” 2017). In other words, digital recruitment can save companies a fortune.

Be Efficient

On top of that, as mentioned earlier, digital recruitment leads to better results compared to conventional methods. Recruiting methods, such as fliers, TV ads, and job boards, seem to be a practice from the past. For instance, a study showed that only 15 out of 320 calls from a newspaper advertisement led to patient enrollment (“A paradigm shift in patient recruitment for clinical trials,” 2017).

In addition, a survey of pregnant women showed that digital recruiting and social media recruiting, in particular, might be a feasible approach to recruiting a huge and diverse sample of pregnant women. Recruiting diverse and vulnerable samples of pregnant women is a crucial part of the reproductive health sector (Admon et al., 2016). Remember that all studies benefit from diverse data

Motivate Participants

Although raising awareness among possible participants is vital, one of the main problems that clinical trial recruitment faces is enrollment. For instance, a study showed that out of 27,000 patients screened over 172 sites, 95% didn’t enroll (“A paradigm shift in patient recruitment for clinical trials,” 2017). To facilitate enrollment, digital recruitment offers an interactive way to involve participants, which is less time-consuming and more cost-effective.

At the same time, studies reveal that participants that enroll rarely reach the final phase of the study. Nevertheless, digital recruitment and mobile technology can motivate people throughout the whole process, which can take research to success. Note that digital recruitment that includes relevant prescreening questions may lead to high rates of enrollment and completion.

Seize the Moment & Embrace the Future

Let’s not forget that digital recruitment eliminates the need of building an expensive software program. On top of that, it eliminates the need for training personnel to go through thousands of medical records. Commercial software programs and CTMS like Qolty can help researchers conduct a study without fearing possible technical limitations. All that can give medical professionals the chance to access data at all times and collaborate with other researchers.

At the same time, digital recruitment, based on social media and search engines, provides researchers the chance to access big and diverse samples of participants (Admon et al., 2016). With the popularity of Facebook ads and Google Adwords, digital recruitment can help you seize the moment and embrace the future of research. The future is 100% interconnected with social media channels.

Digital Recruitment: New Perspectives

Apart from all research details and technical aspects, digital recruitment reflects today’s new perspectives in science and pharmacology. Medicine has changed dramatically. There’s been a major shift in perspectives: patients are not passive observers but active participants that can shape science. In therapy, people are not seen as patients but equal clients. In obstetrics and gynecology, women are not only mothers-to-be but individuals able to seek pain-management information. In science, participants are not lab mice but active contributors.

In other words, patients are the center of research. People use the Internet to collect more information about the topic of interest (Sharma, 2015); and companies and pharmaceutical giants need people to succeed. What’s more, online communities give people the unique opportunity to leave a review and find social support. Companies and patients work together to gather ideas, share feedback, and of course, complete informed consents forms.

Let’s put it this way: patients are the center of research. From financial factors to altruism, many reasons can motivate a participant to enroll and complete a study.  At the same, digital recruitment proves to be effective. We can conclude that digital recruitment should become an established practice among researchers and participants.

Of course, there are various challenges. For instance, when it comes to social media recruitment, researchers have to agree on the definition of social media sites. It’s interesting that Shere at al., 2014 defined sites like Craigslist as social media channel along Facebook. However, a scoping review shows that the combination of social media and standard methods is a complex phenomenon that needs more research (Topolovec-Vranic, 2016).

However, one thing is for sure: Digital recruitment is the most successful method when it comes to 1) recruiting hard-to-reach participants, including younger subjects, 2) involving big and diverse samples, and 3) conducting observational studies. All that easy to manage and cost-effective.

As technological evolution goes hand in hand with scientific advancements, researchers have to explore the rich possibilities that digital recruitment offers. Simply because in our tech-driven society, digital recruitment can take medicine into the bright future of scientific success.

References

A paradigm shift in patient recruitment for clinical trials. (2017, January). Retrieved from http://snomedinside.org/getattachment/fa2fbe5c-6120-4b97-9b97-6d9286c1627c/Clinithink;.aspx;/

Admon, L., Haefner, J.,  Kolenic, G., Chang, T., Davis, M., & Moniz, M. (2016). Recruiting Pregnant Patients for Survey Research: A Head toHead Comparison of Social Media-Based Versus Clinic-Based Approaches. Journal of Medical Internet Research; 18(12): e326.

Nash, E., Gilroy, D., Srikusalanukul, W., Abhayaratna, W., Stanton, T.,Mitchell, G., Michael Stowasser, M., & Sharman (2017). Facebook advertising for participant recruitment into a blood pressure clinical trialJournal of Hypertension.

Topolovic-Vranic, J., Natalajan, K., (2016). The Use of Social Media in Recruitment for Medical Research Studies: A Scoping ReviewJournal of Medical Internet Research; 18(11):e286.

Sharma, N. (2015). Patient centric approach for clinical trials: Current trend and new opportunitiesPerspectives in Clinical Research; 6(3): 134–138.

Shere, M, Zhao, X.,& Koren, G. (2014). The role of social media in recruiting for clinical trials in pregnancy. PLoS One; 26;9(3): e92744.

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