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A gig-economy approach to decentralized clinical trials means visiting a trial participant's home
Bambi Francisco Roizen interviews Hawthorne Effect founder and CEO Jodi Akin. Hawthorne Effect is making clinical trials accessible to everyone, anywhere. The platform doesn't just conduct virtual distributed clinical trials, but hosts a gig economy of 3000 health professionals, called “Hawthorne Heroes”, who visit patients in their homes.
Here's some takeaways:
--- Despite the popularity of decentralized virtual clinical trials, about 95% of all trials should have an in-person component. For trials to be most effective, they require biometrics to understand physiological impacts on heart, blood, lungs and other parts.
--- In-person collection of data enhances the data. By visiting people at their homes, they can also collect social determinants of health data. Social determinants data is essentially non-medical data that contributes to someone's well-being, such as their income, neighborhood, air quality, mobility, safety, etc.
--- Physicians, nurse practitioners, physician assistants make up their 3,000-person gig community. These workers can determine which studies they want to participate in. They get trained on each project and understand the frequency of the visits they sign up for. They can make anywhere from $200 to $1,000 per patient journey.
--- While many decentralized virtual clinical trials focus on expanding access (largely because trials can be done virtually), Hawthorne Effect's value-add is largely adherence. Akin believes the tip of the iceberg is getting people enrolled but the iceberg is getting them through the trial.
--- Some 80% of trials don't finish on time. Even if a trial is for a serious condition, adherence is 80-90% for the first visit, but drops off precipitously after that. For vanity trials (weight loss programs), dropout rates are 50%. Virtual trials don't really improve on those statistics Akin said.
--- Hawthorne Effect's trials support infection disease, rare disease but its sweet spot is cardiovascular.
--- Akin did not get into the economics but did say that the gig economy is a variable cost, and combined with a powerful technology stack, these trials should create cost efficiencies for the sponsors.
--- The company is moving away from per-visit pricing but something that is more predictable and recurring so sponsors can use the platform for multiple trials.
--- Akin would like to focus on diversity. She points out that some statistics have shown that 4% of black Americans are in trials. Even though there have been no studies focused on the impact on black Americans of drugs that were approved based on trials with caucasians, Akin said she believes trials could be more optimized for these different groups. She also noted that women are underserved in treatments and trials.
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