title: Clinical trial resources on the internet must be designed to reach underrepresented minorities.
abstract: OBJECTIVE
  Internet-based clinical trial information services are being developed to increase recruitment to studies. However, there are limited data that evaluate their ability to reach elderly and underrepresented minority populations. This study was designed to evaluate the ability of an established clinical trials registry to reach these populations based on expected Internet use.
  
  
  METHODS
  This study compares general Internet users to participants who enrolled in an Internet based colorectal cancer clinical trials registry established by OncoLink (www.oncolink.org) and the National Colorectal Cancer Research Alliance. Observed rates of demographic groupings were compared to those established for general Internet users.
  
  
  RESULTS
  Two thousand, four hundred and thirty-seven participants from the continental United States used the Internet to register for the database. New England, the Mid-Atlantic region, and the Southeast had the highest relative frequency of participation in the database, whereas the Upper Midwest, California, and the South had the lowest rates. Compared to general Internet users, there was an overrepresentation of women (73% vs. 50%) and participants over 55 years old (27% vs. 14%). However, there was an underrepresentation of minorities (10.3% vs. 22%), particularly African Americans (3.1% vs. 8%) and Hispanics (2.8% vs. 9%).
  
  
  CONCLUSIONS
  The Internet is a growing medium for registry into clinical trials databases. However, even taking into account the selection bias of Internet accessibility, there are still widely disparate demographics between general Internet users and those registering for clinical trials, particularly the underrepresentation of minorities. Internet-based educational and recruitment services for clinical trials must be designed to reach these underrepresented minorities to avoid selection biases in future clinical trials.
authors.affiliation: Fox Chase Virtua Health Cancer Treatment Center, Voorhies, New Jersey 08043, USA. johnjameswilson@gmail.com
authors.forename: John J
authors.initials: JJ
authors.lastname: Wilson
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Mick
authors.forename: S Jack
authors.initials: SJ
authors.lastname: Wei
authors.forename: Anil K
authors.initials: AK
authors.lastname: Rustgi
authors.forename: Sanford D
authors.initials: SD
authors.lastname: Markowitz
authors.forename: Maggie
authors.initials: M
authors.lastname: Hampshire
authors.forename: James M
authors.initials: JM
authors.lastname: Metz
mesh_terms: D001741:Black or African American; D002986:Clinical Trials as Topic; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D018579:Patient Selection