A toolkit to address disparities in digitally enabled oncology trials

Recent advances in digital technologies hold promise to reduce current disparities in cancer care and expand the reach of clinical trials by, for instance, optimising patient’s eligibility screening or enabling patient remote monitoring. However, if equity and patient engagement are not intentionally embedded in the design and execution of digitally enabled trials, such studies risk mirroring the shortcomings of conventional clinical research. To address this, an engagement and equity toolkit has been developed by the WeShare consortium , an academic web platform for digitally enabled cancer research, led by Unicancer under the scientific coordination of the Institut Gustave Roussy, Villejeuf, France, as reported on the ESMO Real World Data and Digital Oncology (ESMO Real World Data and Digital Oncology, Volume 9, 100175).

“Digital technologies are transforming clinical trial operations by improving the efficiency of many processes and digitally enabled trials offer a powerful opportunity to accelerate study execution and reach broader patient populations. However, their promise depends on designing solutions that ensure robust engagement and deliberately address equity barriers in access and participation,” notes Dr Rodrigo Dienstmann, from Oncoclínicas Group, São Paulo, Brazil, and Vall d’Hebron Institute of Oncology, Barcelona, Spain, and Editor-in-Chief of the ESMO’s peer-reviewed journal. “A comprehensive engagement and equity toolkit is essential to realise the potential for digital health to mitigate disparities, making oncology trials more inclusive and representative.”

The proposed toolkit, which is being tested and refined in the setting of different pilot studies at national and international levels, covers key aspects across all phases of clinical research, from clinical trial design to communication of results, including the importance of co-designing digital tools and trial interventions with all stakeholders, providing supportive care within trials to enhance patient participation and experience, and training health care providers to recognise and reduce implicit bias in trial recruitment.

While the platform provides real-time sociodemographic data and periodic reports to researchers to inform them of the quality of diversity and representation in the recruited sample compared with the target patient population, the consortium also advocates for the production of multilingual clinical trials materials that are both readable and understandable to all patients, as well as for more pragmatic clinical trials with simplified inclusion criteria that better align with real-world care practices.