ClinLife is an international patient portal for clinical trials . It is the largest European portal of its kind and currently serves both Europe and North America. Clariness.com. Clariness : The Trial Network Company. 27.07.2010 URL >.; The second largest portal is Volterys with 40, 000 members. See Volterys.de. Volterys. 29.07.2010 URL >. ClinLife ’ s website states that its mission is to assist clinical research centers in their patient recruitment efforts and to provide the public with easier, more transparent access to clinical studies. ClinLife.com. ClinLife. 27.07.2010 < URL ClinLife maintains that all its  services are free to the public and will always remain free. ClinLife is operated by Clariness, an independent company based in Zurich, Switzerland, and with subsidiaries in Germany, the UK, the US and Serbia. History The vast majority of clinical trials are delayed from the outset due to a lack of volunteers. This results in sharp increases in the amount of time the public has to wait for new, effective treatments. CenterWatch Staff. An Industry in Evolution, Third Edition. CenterWatch Inc. , 2001, pg. 204.; SpineMark. com.SpineMark: CRO Management Inc.San Diego:  2008. 29.07.2010 URL Healthmgttech. com.Health Management Technology. August 2009. 29.07.2010 < URL CISCRP.com. The Center for Information    & Study on Clinical Research Participation. 27.07.2010 URL pat.html>.; Roan, Sahri.Medical Clinical Research Slow for Lack of Patients. L. A. Times. March 14 , 2009. URL One aspect of this problem was that as of 2005 there wasn’t a single, comprehensive database that listed clinical studies in Germany. Clinlife. com. ClinLife. 27.07.2010 < URL In December 2005 ClinLife was used for the first time in the Berlin district of Charlottenburg for a trial on diabetes. Many patientswho received information at ClinLifewent on to participate in the study. ClinLife expanded its services to include all of Germany in 2006. Within a few months, ClinLife was also available in Austria and Switzerland. In 2007 ClinLifebegan publishing trials and assisting volunteers in the UK. For the first time, ClinLife was operational in a  language other than German . In 2008 ClinLife expanded once again, this time to  Belgium, the  Czech Republic, France, Italy, the Netherlands, Poland and Portugal. By the end of 2008, ClinLife had more than 1 million visitors. In 2009, ClinLife travelled across the Atlantic and set up its platform in both Canadaand the US,and shortly thereafter, in Hungary and Turkey. More than 600 trials on over 60 illnesses have been published by ClinLife, and more than 30, 000 patients have been put in contact with clinical trial centers, also known as clinical sites.   Current status ClinLife is available in 11 languages in 16 countries and has 120,000 active members. The portal provides general information about illnesses and about   clinical trials. The site publishes trials, explains what they are , how they work, their ethical considerations and why they are important. Specific information about current trialsis also given and a search option helps both healthy volunteers and patients with illnesses to find clinical studies on specific conditions in specific regions. An online screener tests volunteers to see if they fulfill the trial criteria and they are then given the option to be automatically directed to a clinical trial center. A newsletter service also provides members with information via email about specific trials on specific illnesses. ClinLife is operated by Clariness. Clariness works and maintains contracts with research companies and institutes.   
ClinLife is the largest European-based patient portal for clinical trials with over 13 million unique visitors a year and 1 million registered patients from about 50 countries worldwide. BioSpace, 'Clariness Celebrates 10 year Commitment To Accelerating Clinical Trials With ClinLife Enhancements' (30 September 2015) URL EIF, 'Case-study Clariness and ClinLife' URL (accessed 10.05.2021) TrialHealth, 'Clariness Announces Release of ClinLife ® Investigator Portal Version 2.0', January 17, 2018 URL (accessed 10.05.2021) Founded in 2005 by the German company Clariness, it initially operated primarily in the DACH region but since has expanded to the United States, South America, Oceania and Asia. European Investment Fund, ‘EU support for innovative SMEs to accelerate vaccine development ’ (2021) URL Investment Fund|access-date=2021-05-21| ClinLife started in 2005 with the aim to facilitate the participation in clinical research studies and thereby speed up the development of new medication and treatments. It aims to support Contract research organization, research site and Pharmaceutical Research who have historically struggled with reaching and informing patients about relevant clinical trials. BioSpace, 'Clariness Celebrates 10 year Commitment To Accelerating Clinical Trials With ClinLife'(Sep 30, 2015) URL Researchers estimated in 2018 that 86\% of all clinical trials are delayed due to a lack of qualified participants. Huang et al, 'Clinical trials recruitment planning', in: Contemporary Clinical Trials Volume 66 (March 2018) 74-79 URL ClinLife's services are free of charge for participants and are financed in cooperation with research sites and sponsors. Treweek S, Lockhart P, Pitkethly M, Cook JA, Kjeldstrøm M, Johansen M, Taskila TK, Sullivan FM, Wilson S, Jackson C, Jones R, Mitchell ED. Methods to improve recruitment to randomised controlled trials: Cochrane systematic review and meta-analysis. BMJ Open (2013 Feb) URL History The demand for better access to clinical trials originates from before the introduction of the internet. In the late 1980s, HIV-infected men in the gay community pressured the US Congress to improve the accessibility to clinical trials that investigated medication and treatments for AIDS Edward, Kennedy (4 November 1988). "S.2889 - 100th Congress (1987-1988): Health Omnibus Extension of 1988". URL Reagan, Ronald W. (May 4 , 1987). "Statement by Assistant to the President for Press Relations Fitzwater on the Establishment of a National Commission on AIDS - May 4, 1987". Internet Archive. Washington, D.C.: National Archives and Records Service. p. 462. URL ACTIS, 'AIDS Research and Clinical Trials' (accessed 10.05.2021) URL . In response, U.S. Congress passed the Health Omnibus Programs Extension Act in 1988 (Public Law 100-607) which created the first (offline) database for clinical trials. In 1997, the US Food and Drug Administration Modernisation Act turned this databank into an online registry, as it obliged the National Institute of Health to set up a digital register for Clinical Trials 105th Congress, public law 105-115 'food and drug administration modernization act of 1997' page 2295 URL This went online in 2000 under the name ClinicalTrials.gov. Other countries initiated similar initiatives in the mid-2000s, and for example Germany launched the Deutsches Register Klinischer Studien in 2008, while the France and the World Health Organization came with similar initiatives at the same time. In Germany, the governmental Deutsche Klinische Studien Register gained approval of the World Health Organization in 2008. See: DRKS, 'About the project' (05-26-2020) URL for a similar French platform see: Recherche clinique, 'Professionnels de la recherche' URL World Health Organization, 'International Clinical Trials Registry Platform (ICTRP)' (accessed 10.05.2021) URL Most of these platforms however exclusively focus on the national context and are only accessible in the countries language or English. DRKS, 'About the project' (05-26-2020) URL Clinicaltrials.gov, 'What Is ClinicalTrials.gov?' URL (accessed 10.05.2021) With the advent of the internet, patients increasingly began making use of digital platforms as dedicated forums, blogs and social media groups to find information about scientific research on their indications or diagnoses. Nambisan, Priya (2011-05-01). "Information seeking and social support in online health communities: impact on patients' perceived empathy". Journal of the American Medical Informatics Association. 18 (3): 298–304. URL These various online health communities, besides functioning as support-platforms, also were used by patients to share information about new treatment options and clinical trial participation. Nambisan, Priya (2011-05-01). "Information seeking and social support in online health communities: impact on patients' perceived empathy". Journal of the American Medical Informatics Association. 18 (3): 298–304. URL History of ClinLife As ClinicalTrials.gov focused primarily on the American context, and only provided descriptions in English, and mostly in specialist language, in the early 2000s there was no central clinical trial registry for patients in many other countries and languages. Clinicaltrials.gov, 'History' (accessed 10.05.2021 URL StatNews, 'It’s time to make ClinicalTrials.gov a better tool for patients', April 28, 2020 URL For this reason a group of German doctors and web developers decided to set up ClinLife, to simplify the access to clinical trials in Germany. OpenPr Gesundheid & Medizin, 'Starke Nachfrage von Patienten nach Teilnahme an klinischen Studien' 13 November 2007 URL The first study that was hosted on this new ClinLife platform, was a clinical trial study on diabetes that took place in Berlin district of Charlottenburg in December 2005. Xtalks, 'Optimizing Clinical Trial Patient Recruitment from Lessons Learned: From the Burning House to Strategic Collaboration', November 12 , 2015) URL While most patients in the early years of ClinLife were still informed about clinical trials through more old media as radio, television and print, by 2007 these efforts had moved largely to digital media. Life Science Nord Magazine, 'Quest for Success Three ways of turning a promising drug candidate into a marketable product' page 3-7 URL In that same year, the original name of the digital portal was changed from Klinische Forschung Deutschland to ClinLife, opening up the possibility for multilingual use. The first clinical trial studies facilitated by ClinLife in an language other than German took place that same year in the United Kingdom. Biologie Seite Deutschland, 'ClinLife Geschichte', URL (accessed 10.05.2021) 2008 saw ClinLife largest expansion to that date, with it becoming accessible for patients and clinical research sites in Belgium, the Netherlands, the Czech Republic, France, Italy, Poland and Portugal. The availability of clinical trials in these new regions and languages led to a rapid increase in visitors searching for information about clinical trial research, receiving over a million unique visits by the end of that year. Parexel Teams with CLARINESS to Enhance Patient Access and Engagement in China June 12, 2019 URL By 2015 ClinLife was accessible in 25 countries, from almost all the countries in Europe, to the United States, Canada, most of South America and Oceania. That year the 500,000th member worldwide registered on the platform. Clariness Facebook, 'celebrating 15 years of CLARINESS and ClinLife' (accessed 10.05.2021) URL Biologie Seite Deutschland, 'ClinLife Geschichte', URL (accessed 10.05.2021) LIFEpr, 'CLARINESS eröffnet neue Niederlassung in den USA' 11 February 2010 URL In 2018, Clariness, the mother company of ClinLife, acquired the German start-up Viomedo, by then the largest dedicated search engine for clinical trials in Germany. This formed a large stimulation for the further expansion of ClinLife, that with the expansion to China in 2019 became accessible in 50 countries. Health Capital Germany, 'Clariness kauft Berliner Startup Viomedo', 29 October 2018 URL It also completed the facilitation of its 1,000th clinical trial study in that same year. Clariness, 'ClinLife in Numbers' URL Clariness CEO Michael Stadler in 2019 joined the Advisory Board of The Center for Information and Study on Clinical Research Participation (CISCRP). This American non-profit organization, aims to educate the public and policy-makers about clinical trial research. Applied clinical trials online, 'Michael Stadler joins Advisory Board at CISCRP' URL Current status In February 2021, ClinLife received funding from the European Union in the context of the EU innovation investment fund, part of the Framework Programmes for Research and Technological Development, that was launched during the COVID-19 crisis. European Commission, 'EU support for innovative SMEs to accelerate vaccine development', accessed 11.05.2021 URL The European Union in its official release noted that the funding for ClinLife was given with the aim to further "expand its free and user-friendly website where patients worldwide can find relevant clinical trials for their condition". European Commission, 'EU support for innovative SMEs to accelerate vaccine development', accessed 11.05.2021 URL ECCP News, 'EU support for innovative SMEs to accelerate vaccine development', 9 February 2021 URL As of March 2021, ClinLife has supported over 1,200 studies worldwide and has 1.4 million registered users. Partly in response to the rapid increase of visitors, the platform increasingly began focusing on providing information in Plain language about various indications, illnesses and scientific research into new medications and treatments. European Commission, 'EU support for innovative SMEs to accelerate vaccine development', accessed 11.05.2021 URL It also hosts services as an online screening-tests and telephone interviews for potential participants, to ensure that they meet the in- or exclusion criteria for a clinical trials. TrialHealth, 'Clariness Announces Release of ClinLife ® Investigator Portal Version 2.0', 17 January 2018 URL Digital patient recruitment in the future Participants in clinical trial studies traditionally are referred to studies by their private doctors, leading to large differences in participation between social, ethnical groups and gender. Medical News Today, 'Increasing diversity in clinical trials: What can doctors, regulators, and patients do?', 10 July 2020 URL Authorities for a long time have tried to address this problem, and in the United States the health authorities have since the early 2000s put up criteria that demand of clinical trials to include a certain proportion of participants that are women or from ethnical minorities. NIH Policy and Guidelines on The Inclusion of Women and Minorities as Subjects in Clinical Research URL and NIH POLICY AND GUIDELINES ON THE INCLUSION OF WOMEN AND MINORITIES AS SUBJECTS IN CLINICAL RESEARCH - OCTOBER, 2001 URL Flores LE, Frontera WR, Andrasik MP, et al. Assessment of the Inclusion of Racial/Ethnic Minority, Female, and Older Individuals in Vaccine Clinical Trials. JAMA Netw Open. 2021;4(2):e2037640. doi:10.1001/jamanetworkopen.2020.37640 Reaching minority communities has continued to be a problem for clinical trial researchers and even the seemingly widespread public participation in the recent COVID-19 clinical trials was criticized by some researchers and activists for not representing the entirety of the population. Flores LE, Frontera WR, Andrasik MP, et al. Assessment of the Inclusion of Racial/Ethnic Minority, Female, and Older Individuals in Vaccine Clinical Trials. JAMA Netw Open. 2021;4(2):e2037640. doi:10.1001/jamanetworkopen.2020.37640 As governments in recent years have continued to extend requirements for diversity in clinical trials to address issues as sex differences in medicine and underrepresentation of minorities, some researchers have suggested that clinical trials should increase their online presence. Brøgger-Mikkelsen M, Ali Z, Zibert JR, Andersen AD, Thomsen SF Online Patient Recruitment in Clinical Trials: Systematic Review and Meta-Analysis J Med Internet Res 2020;22(11):e22179 doi: 10.2196/22179 URL These studies note that online communication has been able to diversify study participation in clinical trials and, partly for this reason, speed up the process of clinical trials. Brøgger-Mikkelsen M, Ali Z, Zibert JR, Andersen AD, Thomsen SF Online Patient Recruitment in Clinical Trials: Systematic Review and Meta-Analysis J Med Internet Res 2020;22(11):e22179 doi: 10.2196/22179 URL
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with over 13 million unique visitors a year and 1 million registered patients from about 50 countries worldwide. BioSpace, 'Clariness Celebrates 10 year Commitment To Accelerating Clinical Trials With ClinLife Enhancements' (30 September 2015) URL EIF, 'Case-study Clariness and ClinLife' URL (accessed 10.05.2021) TrialHealth, 'Clariness Announces Release of ClinLife ® Investigator Portal Version 2.0', January 17, 2018 URL (accessed 10.05.2021) Founded in 2005 by the German company Clariness, it initially operated primarily in the DACH region but since has expanded to the United States, South America, Oceania and Asia. European Investment Fund, ‘EU support for innovative SMEs to accelerate vaccine development
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s website states that its mission is to assist clinical research centers in their patient recruitment efforts and to provide the public with easier, more transparent access to clinical studies. ClinLife.com. ClinLife. 27.07.2010 < URL ClinLife maintains that all its
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to the public and will always remain free. ClinLife is operated by Clariness, an independent company based in Zurich, Switzerland, and with subsidiaries in Germany, the UK, the US and Serbia.
of charge for participants and are financed in cooperation with research sites and sponsors. Treweek S, Lockhart P, Pitkethly M, Cook JA, Kjeldstrøm M, Johansen M, Taskila TK, Sullivan FM, Wilson S, Jackson C, Jones R, Mitchell ED. Methods to improve recruitment to randomised controlled trials: Cochrane systematic review and meta-analysis. BMJ Open (2013 Feb) URL
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2001, pg. 204.; SpineMark. com.SpineMark: CRO Management Inc.San Diego:
1987). "Statement by Assistant to the President for Press Relations Fitzwater on the Establishment of a National Commission on AIDS - May 4, 1987". Internet Archive. Washington, D.C.: National Archives and Records Service. p. 462. URL ACTIS, 'AIDS Research and Clinical Trials' (accessed 10.05.2021) URL . In response, U.S. Congress passed the Health Omnibus Programs Extension Act in 1988 (Public Law 100-607) which created the first (offline) database for clinical trials. In 1997, the US Food and Drug Administration Modernisation Act turned this databank into an online registry, as it obliged the National Institute of Health to set up a digital register for Clinical Trials 105th Congress, public law 105-115 'food and drug administration modernization act of 1997' page 2295 URL This went online in 2000 under the name ClinicalTrials.gov.
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With the advent of the internet, patients increasingly began making use of digital platforms as dedicated forums, blogs and social media groups to find information about scientific research on their indications or diagnoses. Nambisan, Priya (2011-05-01). "Information seeking and social support in online health communities: impact on patients' perceived empathy". Journal of the American Medical Informatics Association. 18 (3): 298–304. URL These various online health communities, besides functioning as support-platforms, also were used by patients to share information about new treatment options and clinical trial participation. Nambisan, Priya (2011-05-01). "Information seeking and social support in online health communities: impact on patients' perceived empathy". Journal of the American Medical Informatics Association. 18 (3): 298–304. URL
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As ClinicalTrials.gov focused primarily on the American context, and only provided descriptions in English, and mostly in specialist language, in the early 2000s there was no central clinical trial registry for patients in many other countries and languages. Clinicaltrials.gov, 'History' (accessed 10.05.2021 URL StatNews, 'It’s time to make ClinicalTrials.gov a better tool for patients', April 28, 2020 URL For this reason a group of German doctors and web developers decided to set up ClinLife, to simplify the access to clinical trials in Germany. OpenPr Gesundheid
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Study on Clinical Research Participation. 27.07.2010 URL pat.html>.; Roan, Sahri.Medical Clinical Research Slow for Lack of Patients. L. A. Times. March 14
Medizin, 'Starke Nachfrage von Patienten nach Teilnahme an klinischen Studien' 13 November 2007 URL The first study that was hosted on this new ClinLife platform, was a clinical trial study on diabetes that took place in Berlin district of Charlottenburg in December 2005. Xtalks, 'Optimizing Clinical Trial Patient Recruitment from Lessons Learned: From the Burning House to Strategic Collaboration', November 12
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2009. URL One aspect of this problem was that as of 2005 there wasn’t a single, comprehensive database that listed clinical studies in Germany. Clinlife. com. ClinLife. 27.07.2010 < URL In December 2005 ClinLife was used for the first time in the Berlin district of Charlottenburg for a trial on diabetes. Many patientswho received information at ClinLifewent on to participate in the study. ClinLife expanded its services to include all of Germany in 2006. Within a few months, ClinLife was also available in Austria and Switzerland. In 2007 ClinLifebegan publishing trials and assisting volunteers in the UK. For the first time, ClinLife was operational in a
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While most patients in the early years of ClinLife were still informed about clinical trials through more old media as radio, television and print, by 2007 these efforts had moved largely to digital media. Life Science Nord Magazine, 'Quest for Success Three ways of turning a promising drug candidate into a marketable product' page 3-7 URL In that same year, the original name of the digital portal was changed from Klinische Forschung Deutschland to ClinLife, opening up the possibility for multilingual use. The first clinical trial studies facilitated by ClinLife in an
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By the end of 2008, ClinLife had more than 1 million visitors. In 2009, ClinLife travelled across the Atlantic and set up its platform in both Canadaand the US,and shortly thereafter, in Hungary and Turkey. More than 600 trials on over 60 illnesses have been published by ClinLife, and more than 30, 000 patients have been put in contact with clinical trial centers, also known as clinical sites.
The availability of clinical trials in these new regions and languages led to a rapid increase in visitors searching for information about clinical trial research, receiving over a million unique visits by the end of that year. Parexel Teams with CLARINESS to Enhance Patient Access and Engagement in China June 12, 2019 URL
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By 2015 ClinLife was accessible in 25 countries, from almost all the countries in Europe, to the United States, Canada, most of South America and Oceania. That year the 500,000th member worldwide registered on the platform. Clariness Facebook, 'celebrating 15 years of CLARINESS and ClinLife' (accessed 10.05.2021) URL Biologie Seite Deutschland, 'ClinLife Geschichte', URL (accessed 10.05.2021) LIFEpr, 'CLARINESS eröffnet neue Niederlassung in den USA' 11 February 2010 URL In 2018, Clariness, the mother company of ClinLife, acquired the German start-up Viomedo, by then the largest dedicated search engine for clinical trials in Germany. This formed a large stimulation for the further expansion of ClinLife, that with the expansion to China in 2019 became accessible in 50 countries. Health Capital Germany, 'Clariness kauft Berliner Startup Viomedo', 29 October 2018 URL It also completed the facilitation of its 1,000th clinical trial study in that same year. Clariness, 'ClinLife in Numbers' URL
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Clariness CEO Michael Stadler in 2019 joined the Advisory Board of The Center for Information and Study on Clinical Research Participation (CISCRP). This American non-profit organization, aims to educate the public and policy-makers about clinical trial research. Applied clinical trials online, 'Michael Stadler joins Advisory Board at CISCRP' URL
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ClinLife is available in 11 languages in 16 countries and has 120,000 active members. The portal provides general information about illnesses and about
In February 2021, ClinLife received funding from the European Union in the context of the EU innovation investment fund, part of the Framework Programmes for Research and Technological Development, that was launched during the COVID-19 crisis. European Commission, 'EU support for innovative SMEs to accelerate vaccine development', accessed 11.05.2021 URL The European Union in its official release noted that the funding for ClinLife was given with the aim to further "expand its free and user-friendly website where patients worldwide can find relevant clinical trials for their condition". European Commission, 'EU support for innovative SMEs to accelerate vaccine development', accessed 11.05.2021 URL ECCP News, 'EU support for innovative SMEs to accelerate vaccine development', 9 February 2021 URL
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As of March 2021, ClinLife has supported over 1,200 studies worldwide and has 1.4 million registered users. Partly in response to the rapid increase of visitors, the platform increasingly began focusing on providing information in Plain language about various indications, illnesses and scientific research into new medications and treatments. European Commission, 'EU support for innovative SMEs to accelerate vaccine development', accessed 11.05.2021 URL
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It also hosts services as an online screening-tests and telephone interviews for potential participants, to ensure that they meet the in- or exclusion criteria for a
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The site publishes trials, explains what they are , how they work, their ethical considerations and why they are important. Specific information about current trialsis also given and a search option helps both healthy volunteers and patients with illnesses to find clinical studies on specific conditions in specific regions. An online screener tests volunteers to see if they fulfill the trial criteria and they are then given the option to be automatically directed to a clinical trial center. A newsletter service also provides members with information via email about specific trials on specific illnesses. ClinLife is operated by Clariness. Clariness works and maintains contracts with research companies and institutes.
TrialHealth, 'Clariness Announces Release of ClinLife ® Investigator Portal Version 2.0', 17 January 2018 URL
A
Digital patient recruitment in the future
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Participants in clinical trial studies traditionally are referred to studies by their private doctors, leading to large differences in participation between social, ethnical groups and gender. Medical News Today, 'Increasing diversity in clinical trials: What can doctors, regulators, and patients do?', 10 July 2020 URL Authorities for a long time have tried to address this problem, and in the United States the health authorities have since the early 2000s put up criteria that demand of clinical trials to include a certain proportion of participants that are women or from ethnical minorities. NIH Policy and Guidelines on The Inclusion of Women and Minorities as Subjects in Clinical Research URL and NIH POLICY AND GUIDELINES ON THE INCLUSION OF WOMEN AND MINORITIES AS SUBJECTS IN CLINICAL RESEARCH - OCTOBER, 2001 URL Flores LE, Frontera WR, Andrasik MP, et al. Assessment of the Inclusion of Racial/Ethnic Minority, Female, and Older Individuals in Vaccine Clinical Trials. JAMA Netw Open. 2021;4(2):e2037640. doi:10.1001/jamanetworkopen.2020.37640 Reaching minority communities has continued to be a problem for clinical trial researchers and even the seemingly widespread public participation in the recent COVID-19 clinical trials was criticized by some researchers and activists for not representing the entirety of the population. Flores LE, Frontera WR, Andrasik MP, et al. Assessment of the Inclusion of Racial/Ethnic Minority, Female, and Older Individuals in Vaccine Clinical Trials. JAMA Netw Open. 2021;4(2):e2037640. doi:10.1001/jamanetworkopen.2020.37640
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As governments in recent years have continued to extend requirements for diversity in clinical trials to address issues as sex differences in medicine and underrepresentation of minorities, some researchers have suggested that clinical trials should increase their online presence. Brøgger-Mikkelsen M, Ali Z, Zibert JR, Andersen AD, Thomsen SF Online Patient Recruitment in Clinical Trials: Systematic Review and Meta-Analysis J Med Internet Res 2020;22(11):e22179 doi: 10.2196/22179 URL These studies note that online communication has been able to diversify study participation in clinical trials and, partly for this reason, speed up the process of clinical trials. Brøgger-Mikkelsen M, Ali Z, Zibert JR, Andersen AD, Thomsen SF Online Patient Recruitment in Clinical Trials: Systematic Review and Meta-Analysis J Med Internet Res 2020;22(11):e22179 doi: 10.2196/22179 URL