Decentralized Trials & Research Alliance (DTRA) is a 501(c)(3) nonprofit organization in the United States that works to accelerate the adoption of patient-focused, decentralized trials and research within life sciences and healthcare through education and research. DTRA works to make research participation accessible to everyone, enabled by the consistent, widespread adoption of appropriate decentralized research methods.[1]
Dr. Amir Kalali, M.D. and Craig Lipset are the organization's co-chairs and launched the DTRA on December 10, 2020. They discussed the challenges that decentralized research can address in a piece published in STAT on January 29, 2021, where they confirmed that membership in the organization had reached over 100 collaborating organizations that share the mission of DTRA.[2]
Disadvantaged communities have traditionally been largely underrepresented in clinical trials.[3] Decentralized research that leverages available communications, telemedicine, artificial intelligence and other technologies has been proposed as a way to help recruit a more broadly representative patient population by gender, ethnicity, age, geography, income and more.
In an interview in Clinical Leader,[1] Kalali discussed increasing clinical trial options for diverse patient populations and was quoted as saying, "Patients want options, and decentralized methodologies present them with those options. In the future, the average patient will be someone who grew up around the technology and is familiar with using it. If pharma wants to have patients participate in trials, it needs to go where patients want them to be. The younger generation has gotten used to having these technologies in other sectors, and it is how patients will want to interact with trials. The risk for our studies going forward will no longer be whether we can introduce these technologies in our trials. The new risk will be not giving patients new opportunities to engage with trials. This is a real opportunity to create sustained momentum."
MedCity News highlighted decentralized trials as one of the strategies that would make 2021 a "banner year" for life science industries, and cited the DTRA as uniting "industry stakeholders with a singular mission to make clinical trial participation widely accessible by advancing policies, research practices and new technologies in decentralized clinical research".[4]
As a result of travel restrictions and the social distancing required to mitigate against the COVID-19 pandemic, clinical trials were affected worldwide. According to a study published in June 2020 by researchers at the University of Texas MD Anderson Cancer Center, of the 1,052 clinical trials that were suspended during the period from March 1 to April 26, 2020, at least 905 were suspended because of COVID-19.[5]
It has been noted that the impacts of COVID-19 may have set back clinical trial research several years[6] because of prospective patients' reluctance or inability to schedule physical visits at research locations. Decentralized clinical trials have emerged as an answer to that problem, as outlined in a report from Oracle Health Sciences.[7]
Kalali told MobiHealth News in December 2021, "The benefits of decentralized research methodologies have been apparent for some time, but adoption has been slow due to many factors including culture and the lack of a forum for stakeholders to collaborate. The COVID-19 pandemic has forced organizations to adopt decentralized methodologies, which have the potential to broadly accelerate drug development."[8]