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Racing to Enroll, Failing to Retain: The Pitfalls of Competitive Enrollment in Clinical Trials

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In multisite clinical research, speed is often regarded as the primary measure of success. Yet the “fastest to fill” approach to competitive enrollment, rewarding sites for volume and velocity, can undermine the very outcomes clinical trials are designed to achieve: reliable data, sustainable budgets, and participant retention.

In traditional competitive enrollment studies, sites rush to enroll patients who may not be ideal candidates for long-term participation. This creates:

  • High screen-failure rates that erode efficiency and inflate costs.
  • Increased dropout rates that disrupt timelines and data availability.
  • Strained site operations balancing heavy administrative loads and resource constraints.
  • Rushed patient experiences that weaken engagement and increase attrition risk.

Combined, these factors extend budgets and timelines, consume additional resources, and jeopardize the very outcomes trials seek to achieve.


Retention is not simply a metric; it is foundational to the integrity and credibility of clinical research. High screen-failure rates and participant attrition diminish confidence in outcomes, erode operational efficiency, and strain relationships between sponsors, sites, and participants. Addressing these issues requires a model that prioritizes both accuracy and long-term engagement.


ProSciento’s Precision Enrollment flips the script. Instead of incentivizing volume and speed as the only benchmarks, it rewards accuracy, engagement, and retention to help sponsors and sites achieve more predictable, sustainable outcomes.

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Our approach doesn’t just change the process, it changes the results. Studies that adopt Precision Enrollment have seen:

  • 25% fewer screen failures
  • 90% of enrollment targets achieved on time
  • 92% retention through study completion

These outcomes translate into more predictable trial costs, reduced waste of screening materials and investigational products, and stronger sponsor-site relationships.

To illustrate how this model works in practice, consider the following real-world example. This case highlights how moving away from open, volume-driven enrollment to a precision-based model can improve both operational efficiency and participant retention.

A sponsor conducting a multisite metabolic disease trial experienced significant operational challenges under an open-enrollment model, including nearly 40% screen failures and elevated dropout rates. These issues contributed to costly delays and compromised timelines.

ProSciento implemented its Precision Enrollment model:

  • Centralized prescreening ensured that only qualified patients were referred to sites.
  • Strategic site selection paired high-potential sites with dedicated coordinators.
  • Real-time dashboards provided continuous visibility into enrollment and retention metrics.

Results: screen failures decreased by 25%, retention improved by 15%, and enrollment was completed on schedule without compromising quality or participant engagement.

Precision Enrollment represents more than a procedural shift; it reflects a strategic realignment of priorities in clinical research. By elevating retention and engagement to the forefront, sponsors can safeguard timelines, enhance data integrity, and improve the overall experience for sites and participants.

Author:

Casey Ustick, Vice President of Commercial Operations, ProSciento, Inc.

Published October 27, 2025

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