# Adoption of Decentralization: Are Our Perceptions Holding Us Back?

## TL;DR

This paper explores common misconceptions that may be preventing the adoption of decentralized clinical trials and offers ways to overcome them.

## Contribution

The paper identifies and challenges three common perceptions that hinder the adoption of decentralized clinical trials.

## Key findings

- Common perceptions are being identified as potential barriers to decentralized clinical trial adoption.
- Resources and strategies are suggested to address these perceptions and encourage adoption.
- Engaging stakeholders can help build confidence in using decentralized trial design tools.

## Abstract

Incorporating decentralized approaches into clinical trials is a critical innovation with potential implications for improved accessibility and diversity, as well as lower burden for participants and caregivers. As we move forward in a collective effort to modernize clinical trials, we consistently hear of hurdles that interfere with the adoption of decentralized approaches. But are these hurdles really the impediments we think they are? In this commentary, we offer three perceptions that are commonly heard as impediments to the adoption of digital and decentralized clinical trials. Leveraging the Clinical Trial Transformation Initiative’s Digital Health Trial hub of work, interactions with members and regulators, and observations related to adoption, we address those perceptions and note some resources that exist to overcome them. In working through these barriers, we can instill confidence in sponsors and designers to leverage all the clinical trial design tools available to them to advance the use of decentralized approaches.