Methodological Challenges in Online Trials

Murray, Elizabeth; Khadjesari, Zarnie; White, Ian R; Kalaitzaki, Eleftheria; Godfrey, Christine; McCambridge, Jim; Thompson, Simon G; Wallace, Paul

doi:10.2196/jmir.1052

Cited by 195Digital Mental Health InterventionsMobile Health and mHealth ApplicationsStatistical Methods in Clinical Trials

Methodological Challenges in Online Trials

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Murray, Elizabeth, Khadjesari, Zarnie, White, Ian R, Kalaitzaki, Eleftheria, Godfrey, Christine, McCambridge, Jim, Thompson, Simon G, Wallace, Paul·2009·Journal of Medical Internet Research

DOI 10.2196/jmir.1052PMC PMC2762798

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Abstract

Health care and health care services are increasingly being delivered over the Internet. There is a strong argument that interventions delivered online should also be evaluated online to maximize the trial's external validity. Conducting a trial online can help reduce research costs and improve some aspects of internal validity. To date, there are relatively few trials of health interventions that have been conducted entirely online. In this paper we describe the major methodological issues that arise in trials (recruitment, randomization, fidelity of the intervention, retention, and data quality), consider how the online context affects these issues, and use our experience of one online trial evaluating an intervention to help hazardous drinkers drink less (DownYourDrink) to illustrate potential solutions. Further work is needed to develop online trial methodology.

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Program engagement and retention are expected challenges with transition-age youth in general and with remote delivery.
“Program engagement and retention are expected challenges with transition-age youth in general (Kim et al., 2012) and with remote delivery as well (Hanna et al., 2014; Murray et al., 2009; Watson et al., 2018).”
From Intervention development to improve foster youth mental health by targeting coping self-efficacy and help-seeking (2023) · cites this paper as Murray et al., 2009

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Tutorial Methodological Challenges in Online Trials
Murray, E., Khadjesari, Z., Ian, M., White, R., Kalaitzaki, M. E., Christine, M., McCambridge, J., Simon, P., Thompson, G., & Wallace, P. (2015)
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Authors: Murray, E., Khadjesari, Z., White, I. R., Kalaitzaki, E., Godfrey, C., McCambridge, J., Thompson, S. G., & Wallace, P.
Affiliations: University College London (GB)
MRC Biostatistics Unit (GB)
Medical Research Council (GB)
University of York (GB)
London School of Hygiene & Tropical Medicine (GB)
Corresponding author: Murray, Elizabeth
ORCID: Murray, Elizabeth
Khadjesari, Zarnie
White, Ian R
Godfrey, Christine
McCambridge, Jim
Thompson, Simon G
Wallace, Paul
Venue: Journal of Medical Internet Research
Publisher: JMIR Publications Inc.
Published: 2009-04-03
Volume: 11
Issue: 1
Pages: e9
ISSN: 1438-8871 (ISSN-L)
DOI: 10.2196/jmir.1052
PMC: PMC2762798
OpenAlex: W2165002752
Cited by: 195
References: 48
Citations by year: 2026: 1 · 2025: 7 · 2024: 9 · 2023: 13 · 2022: 8 · 2021: 13 · 2020: 11 · 2019: 8 · 2018: 12 · 2017: 17 · 2016: 16 · 2015: 16 · 2014: 6 · 2013: 19 · 2012: 11
FWCI: 15.30
Type: journal article
Language: en
Open access: gold
doi.org
Licence: other-oa
Locations: Journal of Medical Internet Research (publishedVersion, other-oa)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Research Portal (King's College London) (publishedVersion, other-oa)
LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
UCL Discovery (University College London) (submittedVersion)
UEA Digital Repository (University of East Anglia) (submittedVersion)
Funders: Cancer Research UK
National Institute for Health and Care Research
British Heart Foundation (RG/08/014/24067)
Diabetes UK
Alcohol Change UK
Medical Research Council (U.1052.00.006, U.1052.00.001)
Economic and Social Research Council
Topics: Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
Keywords: online trials, online intervention, clinical trial design, participant recruitment, randomization, intervention fidelity, participant retention, data quality, generalizability, internal validity, hazardous drinking
MeSH terms: Clinical Trials as Topic, Delivery of Health Care, Humans, Online Systems, Reproducibility of Results, Randomized Controlled Trials as Topic, Internet

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Methodological Challenges in Online Trials

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