2026 · Journal of medical Internet research · open access
Addressing the Key Challenges of Decentralized Clinical Trials in Europe: Multistakeholder Perspective Delphi Study
Murciano-Gamborino et al.
The finding, in our words
Experts achieved high consensus on recommendations to support decentralised clinical trials in Europe, including training for health care professionals, improving biological sample logistics, and fostering regulatory harmonization. These prioritized solutions aim to overcome barriers to adoption and create more inclusive and efficient research frameworks.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
In four crew members, capillary volumetric absorptive microsampling caught altered acetaminophen pharmacokinetics in flight: Cmax rose to 43,300 ng/mL from 9,110 before flight and clearance fell to 3,890 mL/h from 16,200, pointing to toxicity risk at standard dosing; four people only, but a case for microsampling where no clinic can reach.
Ten decentralised cancer trials run across 47 Veterans Affairs medical centres enrolled 134 patients, nearly a third of them rural and a fifth from minority groups, matching the population the VA's tele-oncology service already reaches. The authors' own caveat stands: remote conduct widened access, and not every trial design can be run this way.
The study observed favourable trends in the accrual of participants residing far from the site and those from underrepresented groups following the implementation of a decentralised clinical trial program.
The Australian Teletrial Programme improved patient access to trials and workforce capability through harmonised processes and training, but broader implementation is limited by workforce turnover, complex approvals, and variable leadership engagement. This highlights that systemic policy and governance support are critical for the sustainable integration of decentralised trial models.
This review suggests that decentralised clinical trials in oncology can improve patient participation and equity but face significant regulatory, logistical and digital hurdles. It concludes that these trials offer a flexible model dependent on specific clinical contexts rather than a universal replacement for conventional methods.