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Methodological Challenges in Online Trials
Open accessAbstract
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 (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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Metadata
- 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
- 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)
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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