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    Decentralized Clinical Trial Elements (DCT Elements)

    Decentralized clinical trial elements are individual components of a trial; eConsent, telemedicine visits, home nursing, direct-to-patient drug shipment, ePRO, wearables, local labs; that move trial activities from the central investigative site to the participant's home or community.

    FDA's 2024 final guidance Decentralized Clinical Trials for Drugs, Biological Products, and Devices defines acceptable DCT designs, sponsor and investigator oversight expectations, and data integrity requirements. Most DCTs are hybrid (some site visits, some remote), not fully virtual.

    DCT elements expand recruitment to underserved geographies and reduce participant burden, but introduce new vendor management and data integration challenges (especially around real-time data review and adverse event capture).

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