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Review
. 2024 Mar 28:10:20552076241242390.
doi: 10.1177/20552076241242390. eCollection 2024 Jan-Dec.

Digital technologies used in clinical trial recruitment and enrollment including application to trial diversity and inclusion: A systematic review

Amy Kasahara  1   2 , Jennifer Mitchell  1   3 , Joshua Yang  4 , Raphael E Cuomo  5   6   7 , Tiana J McMann  5   6   8 , Tim K Mackey  5   6   8
Affiliations
Review

Digital technologies used in clinical trial recruitment and enrollment including application to trial diversity and inclusion: A systematic review

Amy Kasahara et al. Digit Health. .

Abstract

Background: Many clinical trials fail because of poor recruitment and enrollment which can directly impact the success of biomedical and clinical research outcomes. 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.

Objectives: This systematic review has two key aims: (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.

Methods: We conducted a cross-disciplinary review of articles from PubMed, IEEE Xplore, and ACM Digital Library, published in English between January 2012 and July 2022, using MeSH terms and keywords for digital health, clinical trials, and recruitment and enrollment. Articles unrelated to technology in the recruitment/enrollment process or those discussing recruitment/enrollment without technology aspects were excluded.

Results: The review returned 614 results, with 21 articles (four reviews and 17 original research articles) deemed suitable for inclusion after screening and full-text review. To address the first objective, various digital technologies were identified and characterized, which included articles with more than one technology subcategory including (a) multimedia presentations (19%, n = 4); (b) mobile applications (14%, n = 3); (c) social media platforms (29%, n = 6); (d) machine learning and computer algorithms (19%, n = 4); (e) e-consenting (24%, n = 5); (f) blockchain (5%, n = 1); (g) web-based programs (24%, n = 5); and (h) virtual messaging (24%, n = 5). Additionally, subthemes, including specific diseases or conditions addressed, privacy and regulatory concerns, cost/benefit analyses, and ethnic and minority recruitment considerations, were identified and discussed. Limited research was found to support a particular technology's effectiveness in racial and ethnic minority recruitment and enrollment.

Conclusion: Results from this review illustrate that several types of technology are currently being explored and utilized in clinical trial recruitment and enrollment stages. However, evidence supporting the use of digital technologies is varied and requires further research and evaluation to identify the most valuable opportunities for encouraging diversity in clinical trial recruitment and enrollment practices.

Keywords: COVID-19; clinical trials; digital health technology.

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Conflict of interest statement

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: TJM and TKM are employees of the minority-owned small business S-3 Research LLC. S-3 research has previously and is currently supported by the National Institutes of Health—National Institute of Drug Abuse through a Small Business Innovation and Research contract for social media-related research and technology commercialization. The authors report no other conflict of interest associated with this article.

Figures

Figure 1.
Figure 1.
PRISMA flowchart.
See this image and copyright information in PMC

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