Evidence map›Paper›PMID 41680843›Full record

ArticleTrials2026

Building games into multicenter clinical trial systems to boost trial engagement.

Ryan Majkowski, Shannon Hillery, Bradley J Barney, Paul Ryu, Esther Woo, Nichol McBee, Andrew Mould, Lindsay M Eyzaguirre, Elizabeth Holthouse, Karen Lane

Abstract read
In one paragraph

Article in Trials, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ryan MajkowskiDepartment of Neurology, Trial Innovation Center, BIOS Clinical Trial Coordinating Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA. rmajkow1@jhmi.edu.ORCID http://orcid.org/0009-0006-8415-0349
Shannon HilleryDepartment of Neurology, Trial Innovation Center, BIOS Clinical Trial Coordinating Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Bradley J BarneyUniversity of Utah Health, Salt Lake City, UT, USA.
Paul RyuDepartment of Neurology, Trial Innovation Center, BIOS Clinical Trial Coordinating Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Esther WooDepartment of Neurology, Trial Innovation Center, BIOS Clinical Trial Coordinating Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Nichol McBeeDepartment of Neurology, Trial Innovation Center, BIOS Clinical Trial Coordinating Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Andrew MouldDepartment of Neurology, Trial Innovation Center, BIOS Clinical Trial Coordinating Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Lindsay M EyzaguirreDepartment of Neurology, Trial Innovation Center, BIOS Clinical Trial Coordinating Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Elizabeth HolthouseDepartment of Neurology, Trial Innovation Center, BIOS Clinical Trial Coordinating Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Karen LaneDepartment of Neurology, Trial Innovation Center, BIOS Clinical Trial Coordinating Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Funding

Johns Hopkins-Tufts Trial Innovation Center HEAL Pain ERN SupplementU24TR001609 · NCATS · JOHNS HOPKINS UNIVERSITY · PI HANLEY, DANIEL F · 2016 to 2022
$36.3M
MISTIE III_ Lead Grant_ Cluster Application for the Clinical Coordinating CenterU01NS080824 · NINDS · JOHNS HOPKINS UNIVERSITY · PI HANLEY, DANIEL F · 2013 to 2017
$23.2M
Johns Hopkins University Trial Innovation CenterU24TR004440 · NCATS · JOHNS HOPKINS UNIVERSITY · PI DANIEL F HANLEY · 2023 to 2026
$19.6M
NCATS NIH HHS U24TR001609NCATS NIH HHS U24TR004440NINDS NIH HHS 5U01NS062851-05NINDS NIH HHS U01NS080824
6 · The paper itself

Abstract

backgroundWorkplace gamification refers to the translation of ordinary work tasks into a fun thematic framework-using game design elements such as points, competition, and recognition-to enhance engagement and motivation. Clinical trials are lengthy and operationally demanding, leading to low enthusiasm and disengagement. As a trial coordinating center, we successfully put gamification to work as an engagement tool in a series of multicenter clinical trials.

methodsWe combined trial metadata with gamification and concepts around motivation to enhance how we engaged site teams responsible for trial activation, patient recruitment and retention, protocol compliance, and data quality. Using metrics routinely captured within trial data platforms, performance indicators were extracted and converted into point-based scoring systems. Gamified strategies were integrated into start-up and enrollment phases of each clinical trial, as both phases had measurable tasks with defined timelines.

resultsWe successfully gamified the start-up tasks of seven trials and enrollment tasks of nine trials. As start-up tasks were similar, one game fits multiple trials. Gamification was customized, however, for enrollment processes and further adapted to address protocol-specific challenges and periods of suboptimal performance. Drawing from these experiences, we present a set of guidelines that outline key principles and gamification mechanics, serving as instructions for game development in this context.

conclusionGamification guidelines afford a novel approach to align intrinsic motivators for achievement with existing trial infrastructure and performance metrics to enhance trial team engagement across diverse trial settings.

Indexed as

Clinical Trials as TopicMulticenter Studies as TopicResearch DesignResearch PersonnelHumansMotivationPatient SelectionWorkplaceClinical trial performanceMulticenter clinical trialsSite start-upTrial Innovation NetworkWorkplace gamification

Identifiers

PMID41680843
PMCPMC13005411

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.