Author: MRN
The expansion of site networks across the clinical trial landscape has started to come into full bloom, helping to drive greater patient access and diversification. However, as with anything that has not been entrenched in the system, questions, misunderstanding and misinformation start to grow.
With over 200 sites in MRN’s global Site Network, and nearly 20-years’ experience in delivery of innovative clinical trial solutions, we have been able to identify the key myths and mysteries that are still swirling around and provide clarity on how clinical trial success can be achieved with the aid of site network sites.
Dispelling Myths With Data
Myth 1. Site networks are only comprised of sites conducting studies in the same therapeutic indications…
While there are indeed specialized site networks that focus on one therapeutic indication, there are also more generalized site networks that can offer access to a wider range of capabilities in different therapeutic areas. And “generalized” does not mean any less capable, it simply means that there is ability to take on more variation in both therapeutic indication and level of complexity of the trial protocol.1
The site networks that can offer access to a broader range of trials are also not necessarily part of large conglomerates or academia. Just as there are site networks that can offer a broader range when it comes to capability in different indications, there are site networks that can offer more than one “site type.”
Myth 2. Site Networks are only comprised of one site type, just spread across different regions (academic / community)…
As noted above, site networks can comprise of more than one type of site, although, just as with therapeutic indications, there are networks that will only work with one or two site types.
Based on this, many tend to look at larger site networks with well established, private and/or academic research sites in their network. However, while they may be well-funded and well-known, there is no guarantee that they are well supported and efficiently recruiting. Furthermore, often due to location and high public profiles they are more costly, yet tap into the same, thinning population pools – limiting recruitment capabilities and generalizable study results.
However, there are those now looking to site networks that offer a mix of site types in their networks, including supported community and/or trial-naïve sites. These networks will not only likely have a much broader geographical reach but also have far greater access to different patient population pools.2
Of course, the keyword here is supported – look to site networks with demonstrable results of not just supporting community/trial-naïve sites but also developing and empowering the site to better serve the surrounding communities. By enabling long-term success for these sites, the site network is ensuring there is longevity in the sites that they have partnered with while creating a well-balanced healthcare ecosystem in communities.
Myth 3. Community sites and/or trial-naïve sites are only found in more rural/small town areas…
There is a common misconception that community = a rural location. However, the actual definition is far broader – people that live in the same place or having a certain shared characteristic(s). Further, inner-city neighborhoods or boroughs are often very community driven.
As for trial-naïve sites, they can be found anywhere, just like communities. What they lack is exposure, connection, or consideration from Sponsor companies if they have little to no previous trial experience.
It is also important to note that trial-naïve does not automatically mean community site. However, often these sites have similarities – a lack of resources, limited infrastructure, insufficient staffing support and limited/no experience when it comes to running trials.3
So, if these sites are not always the same and not always in rural locations, how and why are they able to reach more patient population pools than typical traditional sites?
Creating Clarity With Experience
Mystery 1. How are Community-based or trial-naïve sites able to recruit more patients?
Community and/or trial-naïve sites may have a few hurdles to overcome when it comes to resources, experience, and infrastructure – but what they may lack in these areas they make up-for in population reach.
Due to financial constraints these sites often face, they are usually located outside the central business districts of cities and towns and are more localized to community-settings. And while they may not have high-profile academic institutions backing them, or private funding, they are usually well-known and have established relationships with those living in the area.
It is these relationships, as well as proximity to people’s homes and schools, that help these sites recruit more patients over an extended period.
A recent MRN case study demonstrated exactly this – more experienced sites may have initially enrolled more patients more quickly, the trial-naïve sites enrolled steadily and enrolled more patients over time.
Mystery 2. How do sites in site networks remain flexible even though they have a central management team?
It is the very fact that there is a central management team that makes it possible for sites in a site network to be flexible. Access to a central management team means access to centralized processes, technology and rapid resource deployment, and site onboarding.
While the phrasing “centralized” may seem counter-intuitive to flexibility, it is in fact the key. By having established systems, procedures, and workflows already in place, these teams are able to support sites teams, review data, and adjust approaches as needed based on centralized insights.
Mystery 3. How are community-based and/or trial-naïve sites able to execute on complex clinical trial protocols?
These sites are able to succeed when they are supported with the right tools and resources for them. There is no “one-size fits all” for sites – each site will have its own unique issues and problems that they will need help with.
And this is where the power of the network that is looking to achieve long-term success with these sites comes into play. The network will complete a feasibility study at the site and then work with the site to provide the right kind of support. This can be a variety of things and may include the placement of experienced research staff to help train and support the existing team, or through recruitment and retention solutions like in-home HCPs that relieve the burden of some site visits that can be done in the patient’s home.
MRN recently supported sites with both in-home and at-site solutions for a complex, multi-country Parkinson’s disease trial, demonstrating that no matter the site, with the right support, they can succeed.
References:
- Bourne Partners, Clinical Trial Site Networks. Market Research Report, Sept 2024. https://www.bourne-partners.com/wp-content/uploads/2024/09/Clinical-Trial-Sites-Market-Update.pdf. Last Accessed June 2025.
- Peters U, et al. Considerations for Embedding Inclusive Research Principles in the Design and Execution of Clinical Trials. Ther Innov Regul Sci. Mar 2023;57(2):186-195. doi: 10.1007/s43441-022-00464-3.
- Leyden, K. How Community-Focused Site Networks Are Transforming The Clinical Trial Landscape. Clinical Leader, Mar 2025. https://www.clinicalleader.com/doc/how-community-focused-site-networks-are-transforming-the-clinical-trial-landscape-0001. Last accessed June 2025.