Decentralized clinical trials involving the use of digital tools to facilitate remote research are gaining momentum. Rapid advancements in digital technologies have supported the adoption of these trials. These innovations facilitate virtual interactions between clinical trial teams and participants by making it easier to collect, transfer and store electronic data. While some studies have demonstrated the potential for these approaches to reduce barriers to clinical trial participation, they are associated with several challenges that may create or worsen existing health inequalities and limit the generalizability of trial results. Here we review the potential for digitally enabled and decentralized clinical trials to enhance clinical trial participation in an equitable manner. We describe the key barriers individuals from underserved groups may face, and provide recommendations to promote equity, diversity and inclusion.

涉及使用数字工具促进远程研究的去中心化临床试验正在获得动力。数字技术的快速发展支持了这些试验的采用。这些创新使收集、传输和存储电子数据变得更加容易，从而促进了临床试验团队和参与者之间的虚拟交互。虽然一些研究表明这些方法有可能减少参与临床试验的障碍，但它们与一些挑战有关，这些挑战可能会造成或加剧现有的健康不平等，并限制试验结果的普遍性。在这里，我们回顾了数字化和分散式临床试验的潜力，以公平的方式提高临床试验的参与度。我们描述了来自服务不足群体的个人可能面临的主要障碍，并提供了促进公平、多样性和包容性的建议。