Problems with remote or online clinical research

Recruiting participants for clinical research studies that take place online can be challenging due to several issues, including limited reach, inaccurate representation, difficulty verifying identities, ethical concerns, low response rates, and competition with other online activities. These challenges can make it difficult to achieve a representative sample and may impact the validity and reliability of the study results.

Going through each issue one at a time:

First of all, in online studies reach is limited to those who have access to the internet and are comfortable using it, which may exclude certain demographics or populations. People can share, and refer people lacking internet access who are eligible, but this is largely ineffective.

Clinical studies seeking elderly participants is the most common example of this – most notably those with alzheimer’s disease. They rarely use internet themselves, yet their caretakers or close family might refer them to a study and help them to come online. Recruiting this population is expensive though, and slow unless the eligible geographical area is vast.

Secondly, there may be a lack of representation from certain populations or demographics due to the limited reach of online recruitment. This can result in an inaccurate representation of the target population and may lead to biased results. Related to the first point with limited reach, some populations have less time or are less inclined to participate in clinical trials. Single mothers is a clear example, and at Wayturn we have seen that their tendency to join clinical trials with a long time commitment is very low.

It can also be difficult to verify the identities of participants in online studies, which can lead to problems with data integrity and reliability. A high compensation sometimes leads to a study getting a lot of sign ups from fraudulent sources. Combined with no reliable way to verify identities, especially if a study is anonymous, this can be a real problem.

Wayturn solves this to some degree, by analyzing participant data. When referrals complete our prescreening questionnaires, we have systems in place to check that they are genuine. This way, we help our clients by saving time, energy and preserve the accuracy of their clinical trial. The data we gather from participants includes email addresses, IP addresses, phone numbers, time to complete the questionnaire, and if they are using a VPN. And using these datapoints we can verify to some extent that the referral is genuine. We offer full refunds for any referrals that are fraudulent, if they do get through our safeguards.

There may also be ethical concerns about obtaining informed consent from participants in online studies, as it may be difficult to ensure that participants fully understand the nature and risks of the study. This is why most clients we work with choose to debrief the participants using phone screening, or by sending over the consent form at a later stage. Wayturn’s role ends at finding the participant, and ensuring that they are genuine and eligible to participate.

A low response rate can be another problem with online recruitment. The response rate for online recruitment may be lower compared to other methods, such as in-person recruitment, which can make it difficult to achieve the desired sample size. However, Wayturn combats this by reaching as many people as possible, and by iterating on the promotional materials until they are as convincing as possible without misleading participants.

Some studies have a larger problem with response rate than others. Studies without compensation often have more trouble than those with. A large time commitment is another deal breaker for many people who would otherwise be interested. But no matter the response rate, it’s always a matter of volume when it comes to digital advertising. Given enough advertising budget and time, we can reach almost any sample size.

The last problem with digital advertising is that our ads directly compete with other online activities. We compete with product ads on social media or and google’s online shopping ads, which can make it difficult to launch cost effective ads. All ads on the internet are priced relative to each other – most often in real time auctions. And this means that the larger budgets of some brands can cause it to become more costly to attract participants. Black Friday, Christmas, etc are more expensive even for clinical trial ads, despite not trying to sell products.

However, in advertising, catching people’s attention is the most important step – and research studies can often stand in stark contrast to the normal social media ads. There is some virtue signaling in sharing ethical research studies, which increases the reach of the ads without any cost. If participation is compensated, ads also stand out in contrast to product ads that ask participants to spend money.

It is important for researchers to carefully consider these challenges when designing and conducting online research studies, and to take appropriate measures to address them. Wayturn is here to help you if you have any questions.