The Future of Decentralized Trial Elements

In a recent video interview with Applied Clinical Trials, Jane Myles, program director, Decentralized Trials & Research Alliance (DTRA), discussed trends and challenges in decentralized clinical trials (DCTs) including misconceptions and the rapid adoption of DCT elements. Myles also highlighted DTRA's initiatives on site adoption, operational planning, and the integration of digital health technologies.

ACT: Looking forward five years, what do you think the state of decentralized clinical trials (DCTs) will be?

Myles: I think it's a yes and. First, I do see a growing slope of adoption and I don't think that's just because I'm a wild optimist. I think that's just because as people age, being digital-first is becoming normal. I know there are lots of concerns about older participants using this technology. By the way, they're accepting it pretty well, maybe more so than other sectors of the population, so I think we're going to see that the gap will narrow. The other thing is, I think that patients are actually going to demand that trial activities reflect how they would act in their daily life. I've been believing that for a long time, but I'm starting to see that's coming.

The other thing that's going to evolve is the use of AI (artificial intelligence) behind the scenes as we run trials as a whole. I'm not sure exactly how that's going to integrate into the DCT domain, but I could imagine a world where you might have chat bots that were able to provide on demand tech support in the language of the participant in real-time to a script that had been approved by the IRB. Imagine, instead of waiting on a phone line, you were able to get at least two levels of questions resolved with an AI bot, and then if you really had a human need, you could connect to that person. That's one way.

I also think actually digital health technologies, DHTs are increasingly—radically increasingly—being used in trials, and they fit so well with DCT methodologies, we're going to see more and more of that pairing. Yes, we are going to send you a continuous glucose monitor, and yes, you are going to be reporting your insulin values, and yes, we're going to see you time and again for some of the other assessments, but you can do all your labs at your local lab. I guess what I imagine is a future where technology as a whole is going to shift the way that trial methods are used.