# Cross sectional analysis of clinical trials search results for cancer patients using a navigator-assisted clinical trials search using five different search engines

## TL;DR

This study shows that current clinical trial search engines miss many eligible trials, even when navigators help, suggesting a need for better systems to improve patient access.

## Contribution

The study reveals significant limitations in existing clinical trial search engines, even when used by trained navigators.

## Key findings

- 140 out of 247 eligible trials were not found on ClinicalTrials.gov despite being listed there.
- All tested search engines showed reliability issues in retrieving clinical trials.
- Trained navigators still faced challenges, indicating greater difficulties for patients and professionals.

## Abstract

Clinical trials play a critical role in providing patients with access to novel treatments and therapies. However, limitations in clinical trial search engines impede healthcare professionals and patients from accessing the most suitable clinical trials. This study aimed to address this issue by conducting a critical analysis of several prominent clinical trial search websites, including ClinicalTrials.gov, Canadian Cancer Trials, Clinical Trials Ontario, Canadian Cancer Clinical Trials Network, and Q-CROC.

To identify areas for improvement, three skilled clinical trials navigators independently curated clinical trial searches for 18 cancer patients over a 2-month period. After verifying patients’ eligibility for enrollment in clinical trials, the navigators documented their search outcomes and identified several limitations in the current search engines.

Careful curation of clinical trials for 18 patients revealed 247 trials. However, 140 eligible trials out of 247 (57% with 95% binomial confidence interval [50%, 63%]) were found only on alternative websites yet not discoverable on the initial ClinicalTrials.gov searches, even though they were listed on ClinicalTrials.gov. Our study revealed multiple deficiencies in available clinical trials search engines. Lack of reliability was repeatedly identified in all search engines.

This study highlights that the current clinical trial search system needs improvement to enhance patient outcomes. It needs to be highlighted that these searches were performed by trained and dedicated clinical trials navigators. The challenges facing patients and health care professionals in navigating would be much greater. The findings from this study can serve as a foundation for the development of enhanced search engines with improved functionality, which will enable healthcare professionals and patients to find and access the most suitable clinical trials with greater ease and accuracy.