Patient recruitment remains one of the most significant challenges in clinical trial execution. Slow patient accrual is a common cause of trial terminations and driver of delays, creating a pressing need for ways to quickly and reliably identify people eligible to participate in studies.1-4 Quest Diagnostics is meeting the need by using its extensive, real-world lab data to provide strategic recruitment services.
The persistence of enrollment challenges, which have slowed drug development for decades, reflects the limitations of the methods traditionally available to contract research organizations (CROs) and pharma companies.
Traditional, digital, and social media reach large numbers of people, but they are imprecise. Only a tiny fraction of patients engaged by the campaigns are referred to trial sites, with many patients only being identified as ineligible after going through expensive screening processes. Site staff and physicians run more precise enrollment campaigns but only have access to small numbers of patients.
The limitations of each individual channel make multi-modal enrollment strategies the key to success. By incorporating diagnostic labs into their strategies, CROs and sponsors mitigate the shortcomings of other techniques and accelerate enrollment. National diagnostic labs have test results for vast numbers of patients, equipping them to identify many people who are likely to be eligible for a trial. Quest leverages its data and outreach capabilities to give customers a recruitment advantage.
“Instead of casting a wide, inefficient net, we target the individuals who matter most, accelerating enrollment timelines and increasing the overall efficiency and success of clinical trials Parag More, Executive Director of Healthcare Analytics Solutions for Lifesciences at Quest Diagnostics, said.
Providing strategic services
Leveraging its data, Quest is uniquely positioned to help CROs and pharma companies accelerate recruitment. The company identifies patients who fit inclusion and exclusion criteria using ICD-10 codes, lab test results, geographic and demographic information, and other data sources such as claims.
Quest develops communication about the clinical study and emails the information to individuals who may meet the eligibility criteria. Connections and trust established over years of providing lab services make Quest a valuable conduit for sponsors and CROs seeking to engage patients. Neither the sponsor nor the CRO learns the identities of the patients.
The solution is built on a data-driven approach that prioritizes finding the right patients from the start. Ultimately, that prioritization results in downstream conversion all the way to referring the patient to a site.
Quest has proven the approach works. The solution revitalized a lupus study by referring four times more patients to sites in three weeks than other tactics managed in seven months. Traditional enrollment strategies, such as patient-reported data, social media ads, and search engine marketing, reached more than 260,000 people in seven months. Yet fewer than 70 patients passed web screening. The attrition continued throughout phone screening and qualification, resulting in two people being referred to sites.
Quest’s clinical database and direct-to-patient outreach drove a faster, more targeted process. In three weeks, Quest reached more than 36,000 patients, 96 of whom completed web screening. Attrition was much lower than for traditional methods, with 45 patients passing web and phone screening and being qualified. Eight patients were referred to the trial site.
While direct-to-patient outreach is Quest’s primary solution, the company can also email physicians to tell them that one of their patients may be eligible for a clinical trial and to share the inclusion/exclusion criteria. The messages prompt and equip physicians to check the eligibility of their patients.
Conclusion
The impact of Quest’s solution on the lupus trial demonstrates the value of incorporating services based on real-world lab data into multi-modal enrollment strategies. Every recruitment tactic and channel has strengths and weaknesses. Adopting a mix of different tactics and channels can emphasize the strengths while mitigating the weaknesses.
Adding services based on real-world lab results, a data-driven and targeted recruitment channel, to the recruitment mix may be a good first step to accelerating enrollment and maximizing clinical trial success.
References
- Williams, R. J., Tse, T., DiPiazza, K. & Zarin, D. A. Terminated Trials in the ClinicalTrials.gov Results Database: Evaluation of Availability of Primary Outcome Data and Reasons for Termination. PLoS One 10, e0127242 (2015).
- Ma, S. et al. Predicting accrual success for better clinical trial resource allocation. Sci Rep 15, 3879 (2025).
- Fultinavičiūtė, U. Trial termination analysis unveils a silver lining for patient recruitment. Clinical Trials Arena https://www.clinicaltrialsarena.com/features/clinical-trial-terminations/?cf-view (2022).
- Glunt, J. Progress Seen in Streamlining of Patient Recruitment and Retention for Trials. ACRP https://acrpnet.org/2020/01/29/progress-seen-in-streamlining-of-patient-recruitment-and-retention-for-trials (2020).
