As decentralized clinical trials, or DCTs, gain popularity, they’re often viewed as a modern alternative to traditional site-based trials. But the reality is more nuanced. Both models offer distinct strengths depending on the study type, patient population, and research goals. And both can benefit from advances in remote monitoring and digital tools.
Choosing the right model is about understanding the needs of the protocol. In many cases, technology gives researchers the flexibility to tailor their approach without compromising data quality or patient experience.
Site visits can be time-consuming and difficult for many patients, contributing to trial dropout rates that can exceed 30%. Travel, scheduling demands, and physical limitations can make participation especially challenging for people in rural areas, with limited mobility, or from underrepresented communities. DCTs can help overcome these barriers by allowing patients to contribute data from home using wearable devices.
At the same time, traditional site-based trials can still offer a low-burden experience, especially when patients are already receiving care during a hospital stay or scheduled procedure. In these cases, integrating wearable devices into existing care settings can enhance data collection without adding extra burden for patients or staff.
Ultimately, accessibility isn’t just about location. It’s about designing the trial around the needs of the patient population and the realities of care.
Digital health tools and wearable technology are often used in DCTs to capture health data from patients in their daily environments. For example, researchers at UCSF used Vivalink's wearable ECG patch to monitor pregnant patients with congenital heart disease and preeclampsia. Participants wore the device for five days each month during pregnancy and postpartum, which allowed researchers to track cardiac activity without requiring extended hospital stays or frequent clinic visits.
While often associated with DCTs, wearable devices also benefit traditional site-based studies. For example, patients receiving chemotherapy may wear a continuous monitoring device during and after visits to detect early signs of neutropenic fever. Unlike periodic spot checks, the device captures subtle temperature shifts in real time and enables intervention without requiring additional visits.
Whether used remotely or in clinical settings, wearable technology helps capture consistent and accurate data over longer periods and provides insights that might be missed with intermittent checks. Instead of choosing tools based on trial format, researchers should focus on how the technology supports their protocol: Does it fill data gaps? Reduce patient burden? Enable earlier detection of meaningful clinical changes?
DCTs can reduce costs by minimizing site visits, lowering travel-related expenses, and improving data collection through virtual tools. Virtual visits and continuous monitoring can also ease operational demands and accelerate recruitment across geographically diverse populations.
That said, implementing digital tools requires upfront investment and ongoing support to keep patients engaged and ensure protocol adherence throughout the trial. Regardless of the trial model, wearable technology can improve efficiency and reduce the risk of data gaps, leading to more consistent data collection and long-term cost savings.
Continuous data collection can provide researchers with a clearer picture of a patient’s health in both remote and site-based settings. With proper training and ongoing support, wearable devices can reliably deliver high-quality data across diverse trial environments. In fact, a recent systematic review found that wearable monitors can capture vital signs as accurately as in-hospital clinical devices.
Trials don’t have to be fully remote to benefit from digital tools. Whether patients are participating from home or in person, wearable technology can help researchers collect more consistent and meaningful data. Learn how Vivalink’s devices and remote monitoring platform support that flexibility and integrate continuous data collection into a wide range of clinical environments.