ReviewNPJ digital medicine2022
Opportunities and counterintuitive challenges for decentralized clinical trials to broaden participant inclusion.
Review in NPJ digital medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
87 citing papers in PubMed, 1 synthesis or guideline pooled it, 132 citations in OpenAlex.
- Recommendations to promote equity, diversity and inclusion in decentralized clinical trials.Nature medicine · 2024Guideline
- Pioneering a Hybrid Decentralized Clinical Trial in South Korea: Assessing Feasibility, Data Integrity, and Participant Perceptions.Clinical and translational science · 2026Trial
- A Real-Life Digital Intervention for Personalized Nutrition in Adults With Overweight or Obesity: Remote Randomized Controlled Trial.Journal of medical Internet research · 2026Trial
- The Effectiveness of Digital Cognitive Behavioral Therapy to Treat Insomnia Disorder in US Adults: Nationwide Decentralized Randomized Controlled Trial.JMIR mental health · 2025Trial
- Trial
- Effects of a Cognitive Behavioral Digital Therapeutic on Anxiety and Depression Symptoms in Patients With Cancer: A Randomized Controlled Trial.JCO oncology practice · 2023Trial
- Feasibility study for a fully decentralized clinical trial in participants with functional constipation symptoms.Clinical and translational science · 2023Trial
- Exploration of smart adherence-monitoring methods in vitamin D-deficient patients: A pilot feasibility clinical study.Clinical and translational science · 2023Trial
- AI-based augmentation of oncology clinical trials.Nature reviews. Clinical oncology · 2026Review
- Feasibility and Methodological Reflections From the Co-Creation of a Randomized Controlled Trial (The Kid's Trial): Decentralized, Child-Led Citizen-Science Study.Journal of medical Internet research · 2026Article
- Social Media Influencer Marketing as a Clinical Trial Recruitment Modality: Tutorial Informed by One Study's Approach.Journal of medical Internet research · 2026Article
- Recommendations for the use of clinical outcome assessments in rare disease drug development.EClinicalMedicine · 2026Review
- Wearable devices and cardiovascular health: revolutionizing remote monitoring and disease prevention.European heart journal · 2026Review
- Participant Choice of Centralized or Remote Trial Engagement: Secondary Analysis of a Nonrandomized Clinical Trial.JAMA network open · 2026Article
- Building HOPE: operationalizing hybrid decentralized oncology clinical trials with community providers beyond traditional healthcare system networks.The oncologist · 2026Article
- An at-home blood collection device for remote immune monitoring by high-parameter flow cytometry.JCI insight · 2026Article
- Direct-to-Participant Enrollment in a Virtual Trial: Lessons Learned From the Heartline Study.JACC. Advances · 2026Article
- Article
- Embracing the Digital Revolution: How Artificial Intelligence is Transforming Clinical Trials in Older Participants.Drugs & aging · 2026Review
- The undue burdens of clinical trial participation: implications for equity, diversity, and inclusion.Trials · 2026Article
27 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Traditional clinical trials have often failed to recruit representative participant populations. Just 5% of eligible patients participate in clinical research. Participants, particularly those from minority groups, cite geographical constraints, mistrust, miscommunication, and discrimination as barriers. Here, an intersectional view of inclusion in clinical trials provides significant insights into the complex and counterintuitive challenges of trial design and participant recruitment. The US FDA have recently proposed that decentralized clinical trials (DCTs) might reduce barriers and appeal to a wider range of participants by reducing the costs and commitments required for patients to participate. While common sense and early evidence suggests that allowing participants to take part in trials at or near home has advantages in terms of convenience, travel, and perhaps even infection control, it remains to be seen if DCT approaches will yield significant improvements on participant inclusivity. Some digital studies aiming to be more inclusive on a single element of inclusion, such as race, have experienced unintended consequences in other elements, like education or gender. Implementing DCTs presents new challenges including the digital divide, the exclusion of certain tests and procedures, complexities of at-home medication delivery, and the need to build new infrastructure. We present a range of challenges and opportunities for researchers to adopt and adapt DCT approaches to create reliable evidence that applies to all of us.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.