2023 · Clinical chemistry and laboratory medicine · paywalled
Remote decentralized clinical trials: a new opportunity for laboratory medicine
Pennestrì et al.
The finding, in our words
Remote decentralised clinical trials can improve patient retention and generalisability by bringing trial activities closer to participants' homes using digital technologies. This matters for decentralised diagnostics as it supports the shift towards patient-centric models that reduce the need for on-site visits and broaden patient inclusion.
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.