Patient Recruitment Bottlenecks
Most trials miss recruitment. Few teams know why.
A structured analysis of patient recruitment bottlenecks — referral, screening, eligibility and retention — and the operational interventions that demonstrably work.
"Where in the recruitment funnel are we losing patients — and what can we change?"
Recruitment fails at four points: referral, screening, eligibility and retention. Diagnose the bottleneck first; bolt-on advertising rarely fixes a structural problem.
Trial recruitment fails for structural reasons. Bolt-on advertising and patient-recruitment vendors don’t fix the problem — diagnosing the funnel does.
What we’re seeing in the data.
Eligibility is the largest leak
Average screen-fail rate >50% in late-stage onc trials.
Referral networks are underutilized
Referring HCPs need clear inclusion criteria + frictionless workflow.
Patient-finding tech helps directionally
AI eligibility matching cuts screen fail by 15–30%.
How to think about it.
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01
Map the recruitment funnel
Referral → screening → eligibility → enrollment → retention.
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02
Diagnose the largest leak
Where the absolute drop-off is biggest.
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03
Match intervention to leak
Eligibility AI for screen fail; referral programs for upstream.
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04
Measure intervention impact
Funnel-level metrics, not gross enrollment.
What separates a good answer from a defensible one.
Onc differs from rare disease.
Some sites are structurally weaker recruiters.
Visit frequency and travel affect retention.
Where the signal comes from.
Common questions.
Does paid advertising help?
Modestly, only after structural bottlenecks (eligibility / referral) are fixed.
Should we use decentralized trials?
Often yes for retention; sometimes worse for screening volume.
Want this answered on your data?
We build decision systems on top of analyses like this — so the next question takes minutes, not weeks.
Talk to a strategist