# Decentralised and hybrid clinical trials

Source: https://onco.cc/technologies/decentralised-clinical-trials/  
OnCo record `decentralised-clinical-trials` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Running parts of a trial at home or locally, with telehealth, home nursing, and remote monitoring, so patients far from big centres can take part.

## Summary

Accelerated by the pandemic and FDA guidance (2023-24), decentralised elements include telehealth visits, home infusion or blood draws, local imaging and labs, direct-to-patient drug shipping, and wearables. Vendors: Science 37 (acquired by eMed 2024), Medable, THREAD, Lightship, Walgreens/CVS trial services (partly wound down). Oncology adoption lags other areas because of IV drugs and imaging, but hybrid designs (local labs, remote consent) are common.

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-09-08
- Tags: supporting
- Principle: Decentralised trials combine remote consent and data capture, mobile nursing networks, and local investigator sites coordinated through a central protocol.
- Strengths: Access and diversity; Retention
- Limitations: IV regimens and imaging need sites; Data quality and oversight; Vendor consolidation

## Sources

- Unger: most patients never get the chance to join a cancer trial, and when offered, half say yes (JNCI: Journal of the National Cancer Institute 2019): https://doi.org/10.1093/jnci/djy221

## Connected records

- fronts: [AI & Computation](https://onco.cc/fronts/ai-computation/), [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [Clinical trial software (EDC, eCOA, CTMS, RTSM)](https://onco.cc/technologies/clinical-trial-software/), [Electronic patient-reported outcomes and remote monitoring](https://onco.cc/technologies/remote-patient-monitoring/), [Telemedicine, teleoncology, and telepathology](https://onco.cc/technologies/telemedicine-teleoncology/)
- companies: [Medable](https://onco.cc/companies/medable/), [Science 37 (eMed)](https://onco.cc/companies/science-37/)
- key papers: [Unger: most patients never get the chance to join a cancer trial, and when offered, half say yes](https://onco.cc/key-papers/paper-unger-trial-participation-barriers-jnci-2019/)
- terms: [Accrual and enrolment](https://onco.cc/terms/accrual/), [Clinical Trials Regulation (EU) No 536/2014 and CTIS](https://onco.cc/terms/eu-clinical-trials-regulation/), [ICH good clinical practice (E6)](https://onco.cc/terms/ich-gcp/)

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