Recommendations to promote equity, diversity and inclusion in decentralized clinical trials

Decentralized clinical trials involving the use of digital tools to facilitate remote research are gaining momentum. The 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. Whilst some studies demonstrate the potential for these approaches to reduce barriers to clinical trial participation, they are associated with several challenges which 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.