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Digital recruitment strategy yielded 1,406 registrations from 1,319 potential individuals with atrial fibrillationDigital Ads Help Recruit Patients for Atrial Fibrillation Trials

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Key Takeaway
Note that digital recruitment yields results but may not be sufficient to improve diversity in atrial fibrillation trials.

This observational study evaluated the feasibility of a digital recruitment strategy for individuals with atrial fibrillation in the United States. The study utilized online advertisements and a pre-screening website to identify and recruit participants. A total of 1,406 individuals completed the online registration process.

Demographic data for the recruits included 547 (41.5%) women, 59 (4.5%) African American, and 44 (3.3%) Latino participants. Regarding recruitment efficiency, the study recorded 334 recruits per $100,000 in advertising spend for women, 36 for African Americans, and 27 for Latinos.

Analysis of cost per impression and cost per click showed modest inverse associations with CBSA-level income (R2=0.058, p<0.001 and R2=0.038, p=0.005, respectively). However, there were no significant associations between CBSA-level income and recruitment yield for African Americans (p=0.99), Latinos (p=0.37), or women (p=0.21).

Safety and tolerability data were not reported. A primary limitation is that digital recruitment alone may be insufficient to improve trial diversity, as minority representation remained limited. These findings suggest that while digital tools are a viable recruitment method, they may not independently solve diversity challenges in atrial fibrillation clinical trials.

How this fits prior evidence

How this fits prior evidence: This study addresses a gap in the methodology of trial recruitment for atrial fibrillation. While prior coverage has highlighted the clinical management of atrial fibrillation, such as the use of DOACs to lower stroke and hemorrhage risks and the use of AI-enabled devices for early detection, this study focuses on the logistical feasibility of recruiting patients for such clinical trials. It does not directly relate to the clinical outcomes of DCLV, POAF, or antiplatelet therapy mentioned in prior coverage.

Researchers looked at how digital tools, like online ads and pre-screening websites, could help find people for clinical trials involving atrial fibrillation. The study followed 1,319 people in the United States to see how many people signed up through these online methods and what the costs were for different groups.

The results showed that online ads successfully brought in over 1,400 people. However, the number of participants from minority groups remained low. For example, only 4.5% of those who signed up were African American and 3.3% were Latino. The study also found that while local income levels affected the cost of showing ads, it did not change the number of people from minority groups who signed up.

It is important to note that this was an observational study focused on recruitment methods rather than medical treatment. While digital tools are helpful, the researchers noted that online ads alone might not be enough to fully improve diversity in medical trials. Patients should talk to their doctors about the best ways to participate in clinical research.

What this means for you:
Digital ads can help find more people for heart studies, but more work is needed to reach diverse groups.

Common questions

How much did the digital advertising cost for different groups?

The study measured recruitment per $100,000 spent on ads. They found 334 recruits for women, 36 for African Americans, and 27 for Latinos. While local income levels affected the cost of showing ads, it did not change the number of participants recruited from minority groups.

Is this study about a new treatment for atrial fibrillation?

No, this study did not test a new medication or treatment. It was an observational study focused on the effectiveness of digital tools and online advertisements to help find and recruit people for clinical trials.

Study Details

Study typePhase3
Sample sizen = 1,319
EvidenceLevel 2
PublishedAug 2026
View Original Abstract ↓
Background: Recruitment of diverse participants remains a challenge in cardiovascular clinical trials. Little is known about how recruitment efficiency and advertising costs with web-based tools vary across US communities. We evaluated an online recruitment platform and examined the cost of acquiring both all-comers and diverse participants in relation to community-level income. Methods: The Heartbeat Study evaluated a digital recruitment strategy to identify US participants for the ongoing Phase 3 LIBREXIA-AF trial. Online advertisements directed individuals with atrial fibrillation to a pre-screening website, where demographic and health data were collected. Advertising impressions, clicks, and costs were recorded. Participant ZIP codes were linked to Core Based Statistical Areas (CBSAs) and CBSA-level income. We measured recruits from underrepresented groups (women, African Americans, Latinos) completing online registration per $100,000 in advertising expenses. Click-weighted linear regression evaluated associations between CBSA income and advertising efficiency. Results: A total of 1,406 recruits completed online registration, with 1,319 participants from 260 CBSAs included in the geographic analysis. Participants were 73 years old on average; 547 (41.5%) were women, 59 (4.5%) African American, and 44 (3.3%) Latino. A total of $163,949.13 was spent on 82,681,711 impressions and 454,750 clicks. Recruits per $100,000 in advertising spend were 334 for women, 36 for African Americans, and 27 for Latinos. CBSA-level income was modestly inversely associated with cost per impression (R2=0.058; p<0.001) and cost per click (R2=0.038; p=0.005), but not recruitment yield for African Americans (p=0.99), Latinos (p=0.37), or women (p=0.21) (R2 range, 0.000-0.13). Conclusions: In this national analysis, online advertising enabled broad engagement across diverse US communities, but income was not associated with recruitment yield among women, African American, or Latino participants. Minority representation remained limited, suggesting digital recruitment alone may be insufficient to improve trial diversity. Targeted, culturally and linguistically tailored strategies may be needed to enhance diverse recruitment.
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