Arch Intern Med -- Effect of a Clinical Trial Alert System on Physician Participation in Trial Recruitment (Embi et al 2005)

Patient referral and recruitment are important rate-limiting steps of clinical trials. It is not surprising that electronic health records (EHRs) can automate some of the mechanical steps involved and remind busy practicing physicians that the patient they are seeing may qualify for a particular trial.

In this study, a clinical trial alert (CTA) system was built on top of an existing EHR, and the rates of patient referral and recruitment before and after implementation was compared. They found:
- 10x increase in the number of referrals made by physicians who referred This effect was seen not only at sites that previously did not refer, but also at sites that previously generated the bulk of the referrals.
- 2x the patient enrollment rate With an EHR in place, researchers can determine the eligibility of referred patients directly on their computers. This simplifies the process and allows them to use lowered thresholds for screening. While this raises false-positive rate, it also tends to increase recruitment rate as well (Bell-Syer et al 2000).

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