Site growth

How to decide which clinical trials your site should take

By TrialNotice · Updated
Principal investigator and site director weighing two study protocols side by side at a desk
Short answerTake trials your site can fill and afford: studies whose patients you can reach through your records and referral network, whose budget covers screen failures and recruitment, and whose visit burden your staff can carry. Declining a study you cannot enroll protects your record, because sponsors remember under enrolling sites.

Why does study selection matter so much?

Because the cost of a bad fit lands on both sides. In a typical trial, 11% of sites enroll no patients and 37% under enroll (Tufts CSDD). For the sponsor, Phesi estimates a site that enrolls one patient over a 30 month study costs about $130,000 (Applied Clinical Trials). For the site, it means a weak record with that sponsor and unpaid work.

What does the financial picture look like for sites?

Thin. SCRS reports 88% of sites say screen failures are not sufficiently covered (SCRS). In its 2024 survey, 53% of sites regularly pay for recruitment from their own funds, and prescreening (38%) and screen failures (36%) were the most underfunded budget areas (SCRS). A study with hard to find patients and weak screen failure terms can lose money even when enrollment succeeds.

How have protocols changed the decision?

Protocols have become harder to fill. The number of eligibility criteria in a typical Phase III protocol rose from 31 to 50 between 2002 and 2012 (Tufts CSDD, Getz). Sites that once said yes to most studies now need a real screening process for the studies themselves.

What should be on your study selection checklist?

  1. Patient access. How many patients in your records meet the key criteria?
  2. Referral sources. Do you have, or can you build, relationships with the specialists who manage this population near your site?
  3. Criteria complexity. Which criteria will cause most screen failures?
  4. Competing studies. Will this study compete with another at your site for the same patients?
  5. Budget terms. Are screen failures, prescreening, and recruitment paid?
  6. Staff capacity. Can your coordinators carry the visit schedule?
  7. Sponsor fit. Is this a sponsor you want repeat work from?

If the answer to the first two is weak, the rest rarely matter. For the detailed protocol check, see how to review a protocol for enrollment risk.

Get your study in front of the right local physicians

TrialNotice builds a physician referral pipeline around one active study. We identify relevant local physicians within driving distance of your site, send study aligned direct mail, follow up by email and LinkedIn, track engagement with recipient level QR codes, and route warm responses into your site team's workflow.

Talk to TrialNotice

Sources

  1. Tufts CSDD, patient recruitment and retention practices study (Jan 2013), via Fierce Biotech
  2. Applied Clinical Trials, "Phesi Report: Assessing Single Patient Investigator Sites in Cancer Clinical Trials"
  3. Society for Clinical Research Sites, Site Finances White Paper (2024)
  4. SCRS 2024 Global Site Landscape results, Site Solutions Summit
  5. Ken Getz, Tufts CSDD, "The Cost of Clinical Trial Delays" (CTTI presentation)

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