Category Archives: Clinical

Validation of patients for non-interventional clinical studies

In November 2018, Global Perspectives™ jointly presented a paper at ISPOR about increasing the level of validation among rare patients who will take part in non-interventional clinical studies. In this blog, I want to briefly summarise the findings to explain how Global Perspectives™ can help tailor the recruitment strategy at the correct level of validation. You can find the full presentation at this link.

When recruiting patients, particularly if they are rare patients, the recruitment strategy should be designed to suit the target audience. Often a large sample size is needed in order to provide confidence in the data. A combination of recruitment techniques is more likely to result in a large sample size. Different recruitment sources have different levels of validation associated with them. The below list is ordered from the most validated to the least validated sources of patients:

  • Clinical sites
  • Physician referrals
  • Patient associations
  • Recruiter networks
  • Patient referrals
  • Social media groups
  • Patient panels
  • Consumer panels
  • Open survey links

Validation of patients is allied to patient knowledge, engagement and honesty. If the eligibility criteria is too technical then patients may not know whether they fit the validation criteria. If patients are not engaged, for example, during a long and repetitive survey then they might not be giving their full attention, and there is a risk of a dishonest respondent completing the study if proper checks and not put in place during the recruitment stage.

The following methods can increase the validation of patients for non-interventional clinical studies:

  • Careful selection of recruitment techniques
  • Confirmation of diagnosis by Dr’s notes, CRFs, photos of medication or copies of healthcare records
  • Using experienced human recruiters to check validation of patients and to ensure that patients are engaged. Patients with rare diseases are usually very engaged to share their experiences for a clinical study so it is important that the recruiter can explain the study objectives in a clear way to patients
  • Using a good hidden screener that has been tested on patients to be understandable
  • Checking and removing bad data. For example, respondents who have completed the survey too quickly without fully considering their answers

Global Perspectives™ can help design the right recruitment and validation strategy for your project. Please get in touch with Joe Waby for more information.




Global Perspectives™: Supporting CROs via patient, HCP and payer recruitment

At Global Perspectives™, we specialize in supporting Contract Research Organizations. Over the past few years, our CRO client base has grown tremendously.

Global Perspectives™ are the experts at patient, HCP and payer recruitment for market research and pre/post clinical trial interview purposes.

Patient, HCP and payer recruitment is essential for the success of many patient outcomes, health economics and market access projects. We focus on maximizing the feasibility of audiences in the most cost efficient manner. In this way, we can recruit hard-to-reach patients, HCPs or payers for elicitation, cognitive debriefing, and other qualitative interviews. By combining and choosing from an array of recruitment methodologies, we can also obtain large samples for quantitative surveys.

Global Perspectives™ work in over 50 countries every year by combining a central PM Team with Local Experts in each country. Our SOPs ensure that Local Experts all work to the same high standards of quality.

While our core expertise is in the recruitment of patients, HCPs and payers, our complementary services ensure we provide the maximum value to our CRO clients:

  • Confirmation of diagnosis. For patient recruitment, we have a number of different validation levels, the maximum of which is confirmation of diagnosis by obtaining a signed Dr’s note confirming the patient’s diagnosis. In this way, the study authors can be assured of the validity of the respondents
  • Submission for ethics approvals is often essential if the study will later be published in a scientific journal
  • Moderation and survey scripts. We have a network of experienced healthcare moderators around the world and have an expert team of survey scripters that script and host online surveys according to the latest data protection standards
  • Our team of translators translate survey materials and provide English transcripts of qualitative interviews

Please get in touch if you would like to discuss how Global Perspectives™ can help you. We would love to hear from you!

Global Perspectives are the best choice for recruiting for patient outcomes studies

At Global Perspectives, we specialise in recruiting hard-to-reach patients for patient outcomes studies.

Our ability to create a unique recruitment strategy for each and every project, bring in specialist Local Expert recruiters from all over the world means that we can reach larger numbers of hard-to-reach or rare patients than anyone else. We recruit patients via the following recruitment methodologies:

  • Physician referrals
  • Patient Associations
  • International network of recruiters
  • Online patient panels
  • Social media targeting
  • Traditional advertising

Coupled to our incredible feasibility is the way that we can validate patients in a number of ways, including via telephone or face-to-face screening or via clinical confirmation of diagnosis.

Recent large international patient outcomes studies we have recently worked on include studies for Multiple Myeloma, COPD and asthma, Haemophilia, Renal Cell Carcinoma and Short Bowel Syndrome. We have successfully completed hundreds of such studies over the past few years.

Whether you need a few patients for exploratory interviews or a large online survey with hundreds of patients in 24 countries, please contact Joe Waby so we can explore feasibility and send you our recruitment plan.


Global Perspectives™: Supporting clinical trials via patient interviews

Over the past few years, Global Perspectives™ has been increasingly involved in projects to support clinical trials by conducting semi-structured qualitative interviews with patients that are selected to take part in these studies – all over the world.

The objective is to add greater depth to the clinical outcome assessment (COA) by learning from the patients’ own experiences, expectations and emotions around the trial from start to finish. The interviews are often designed to capture reported symptom changes and patient perception of the treatment. The interviews deliver valuable insights for the interpretation of Patient Reported Outcomes (PROs) and for possible trial design modifications.

Assuming that patients are screened, selected and consented by clinical site staff, Global Perspectives provide experienced moderators that interview in the native language at the site, at an external facility, or by telephone. The first interview is often just after patient selection with follow-up interviews taking place throughout the duration of the trial. We encourage the first interview to be conducted face-to-face so that the moderator builds trust and rapport with the patient. However, the location and interview method is entirely up to the patient.

The number of interviews will vary depending on the enrolment period, length of the trial and overall purpose and need for patient feedback. For example, a trial requiring a surgical procedure may be scheduled to take 2-3 years and the project may define that six interviews with each patient will be conducted with the following intervals:

  1. Just after selection and enrolment
  2. 2 weeks after the procedure
  3. 6 weeks after
  4. 6 months after
  5. 12 months after
  6. When the patient exit’s the clinical trial, is cured or resumes standard care

The interview length may vary from 30-60 minutes for the first interview to just 10-15 minutes for the follow-up and final interviews.

Global Perspectives™ can also combine conventional face-to-face and telephone interviews with electronic diaries. This is particularly useful if a frequent record of events is deemed beneficial for the subsequent analysis.

If you would like to discuss how Global Perspectives™ can support your clinical trial, please contact Kjetill Howard.


Global Perspectives™: Obtaining Ethical Approvals Across Europe for Outcomes Research

Over the past 12 months at Global Perspectives, we have obtained a lot of knowledge and experience regarding ethical approvals for market research studies in Europe.

Many of our healthcare clients obtain US IRB approval for their Patient Outcomes and other market research projects. However, they are less certain on what approval is needed around Europe.

Each country in Europe has different rules and regulations regarding when ethical and regulatory approval is needed. From our experience, we can summarise the following:

  • In general, ethical approval in Europe is not needed if it is a market research study and recruitment will not be taking place at clinical sites
  • However, ethical approval may be desired if the research will be subsequently published in a scientific journal
  • Obtaining FEKI approval in Germany is a good option as this is fairly quick and straight forward and recognised in many countries across Europe
  • Other countries such as France may simply require the project to be registered with the relevant regulatory body

For further information on how Global Perspectives can help you obtain Ethical approvals for your healthcare market research studies, please contact Joe Waby at

Global Perspectives™: A short guide to recruiting payers across Europe

Over the past 12 months, we have seen an increased demand from our clients for recruiting and interviewing payers across Europe.

Now that we have completed a numbers of healthcare payer projects, we wanted to share a little of what we have learned:

  • Payers tend to work for drug advisory boards and purchasing committees either at national or regional administrative level, at medical insurers or at local hospitals or clinics
  • Identifying exactly who is a payer and whether you will want to speak to them depends on the regulatory healthcare environment in each country. For example, most of the hospitals in Germany are part of bigger hospital groups where drug purchasing is centrally regulated. In Austria, the Medical Insurer Drug Advisory committees are very policy-relevant at national level.
  • Recruiters must have a good knowledge of the national, regional and local drug purchase decision making process in each country in order to decide who we can target for the study recruitment, and how many participants we could possibly achieve. Determining the recruitment strategy based on previous experiences is specially key for the success of this type of projects.
  • The responsibilities of payers varies according to each country. For example, payers in Spain tend to be associated with each autonomous region. Payers in France can be national or local in scope, but national payers belong to the public administration and are usually not open to being interviewed

We have successfully recruited and interviewed payers in 12 European countries in the past 12 months. We are therefore able to give you advice about your payer project during the planning process.

As we learn more at Global Perspectives™, we will update you. We are currently exploring the payer environment in countries outside Europe such as Russia, Egypt and Thailand.

Please contact Diana de la Punte for more information.


Global Perspectives™: Recruitment and validation of patients via social media for clinical studies

Social media is a great way to find potential patients for your clinical study, but in order to produce reliable data, patients must first be validated.

Social media is becoming an increasingly fruitful way to recruit patients for market research studies. Social media gives us a fantastic opportunity to communicate directly with large numbers of patients through their smartphones which they carry around with them every day.

At Global Perspectives™ we recognise the importance of process and validation during the social media recruitment process. This enables us to minimize risk and ensure that patients are who we think they are.

Global Perspectives™ are here to help you recruit patients via social media quickly, accurately and reliably.

Recruitment methods and process

Patients of all kinds, including hard-to-reach patients often use social media to help find information and support for their disease or condition. This allows us to target and find patients for market research surveys in a number of different ways.

Via patient association social media pages

Global Perspectives™ have agreements with many patient associations around the world. Patient associations will post information about the project on their social media pages (usually Facebook and sometimes on their own website community pages). Patients will be prompted in the advert to contact either the recruiter or the patient association to register their interest in the study. The recruiter will then call the patient to go through the screening process.

Via social media targeted advertising

Global Perspectives™ have the ability to target patients via Facebook adverts that appear on the patients’ Facebook homepage. The advert appears on the page of those people who have been searching or talking about a certain disease recently. For example, in a recent project, we recruited 10 Hodgkin Lymphoma patients in the UK by advertising on the Facebook pages of people who had searching in Google for Hodgkin Lymphoma or who have liked pages about Hodgkin Lymphoma on Facebook. We can also select patients according to their geography.

Validation of patients

Whichever way we find patients, it is essential to be able to validate patients to ensure that they are who they say they are.

Recruiter validation

All patients who show an interest in the project via social media are screened by an experienced professional healthcare recruiter. This gives a chance for the recruiter to discuss the project with the respondent. We also recommend that the recruiter goes through the screening questions with the respondents so we can ensure that the respondent meets the eligibility criteria. This holds true even when recruiting for online surveys.

Closed survey links

We do not recommend posting open online survey links on social media. This can be seen as an invitation for fraudulent behaviour, not by the patients, but by other members of the social media platform who are attracted by the survey incentives. Using an open survey link means that anyone in the world can complete the survey and any resulting data cannot be trusted. We recommend using social media to find patients, but then sending a unique survey link to validated patients via email.

Disguised screeners

Whatever way we validate patients, we must ensure that respondents cannot guide the eligibility criteria in the screening questions. If a wide range of potential respondents are invited to complete the screening section then it is important that the screener is disguised to ensure that a respondent cannot guess what options they need to pick in order to become eligible for the survey. If we cannot disguise the official screener then sometimes we will use a pre-screener as part of the social media selection process.

Confirmation of diagnosis

Increasingly, clients are asking Global Perspectives™ to obtain confirmation of diagnosis from patients when recruiting them for market research studies that later will be published in a scientific journal. This is an excellent way of ensuring that patients are eligible for the survey and that all resulting data will be valid. Exactly how we do this depends on the patient group, but it can be done in a number of ways:

  • Asking patients to take a validation of diagnosis note to their nurse or physician so that it can be signed by then
  • Recruiting via physicians who also agree to validate the diagnosis of their referred patients (with patient consent)
  • Asking patients to take a photo of their medication
  • Any other proof of diagnosis such as Doctor visit summary printouts or a screenshot of their healthcare patient portal

Semi-automated validation

At Global Perspectives™, we are working on a semi-automated validation process for when recruiting patients via social media. This process may be similar to that used by online panel companies to validate their panel members and may use tools such as “respondent profile checks” by comparing a respondent’s social media profile to a profile questionnaire. We expect to have more details about this later in the year.

Social media is just one of the recruitment strategies that Global Perspectives™ use to recruit patients around the world. We are here to help our clients decide whether to use social media recruitment for any particular project, and if so, the best way of reaching and validating those patients. Please contact Joe Waby for more information.

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