Background: Web-based screening may be suitable for identifying individuals with presymptomatic latent diseases for recruitment to clinical studies, as such people do not often visit hospitals in the presymptomatic stage. The promotion of such online screening studies is critical to their success, although it remains uncertain how the effectiveness of such promotion can differ, depending on the different promotion methods, domains of interest, or countries of implementation. Objective: The Japanese Trial-Ready Cohort (J-TRC) web study is our ongoing online screening registry to identify individuals with presymptomatic Alzheimer disease (AD), aimed at facilitating the clinical trials for AD prevention. Within the first 9 months of its 2019 launch, the J-TRC web study recruited thousands of online participants via multiple methods of promotion, including press releases, newspaper advertisements, web advertisements, or direct email invitations. Here, we aimed to quantitatively evaluate efficacy and cost-effectiveness of each of these multimodal promotion methods. Methods: We applied the vector-autoregression model to assess the degree of contribution of each type of promotion to the following target metrics: number of daily visitors to the J-TRC website, number of daily registrants to the J-TRC web study, daily rate of registration among visitors, daily rate of eligible participants among registrants, and median age of daily registrants. The average cost-effectiveness for each promotion method was also calculated using the total cost and the coefficients in the vector-autoregression model. Results: During the first 9 months of the reviewed period from October 31, 2019 to June 17, 2020, there were 48,334 website visitors and 4429 registrations (9.16% of 48,334 visitors), of which 3081 (69.56%) were eligible registrations. Initial press release reports and newspaper advertisements had a marked effect on increasing the number of daily visitors and daily registrants. Web advertisements significantly contributed to the increase in daily visitors (P<.001) but not to the daily registrants, and it also lowered the rate of registrations and the median age of daily registrants. Website visitors from the direct email invitation sent to other cognitive registries seem to have registered with the highest reliability. The calculated average cost-effectiveness for the initial press release was US $24.60 per visitor and US $96.10 per registrant, while the calculated average cost-effectiveness for the newspaper advertisements was US $28.60 per visitor and US $227.90 per registrant. Conclusions: Our multivariate time-series analysis showed that each promotion method had different features in their effect of recruiting participants to the J-TRC web study. Under the advertisement condition settings thus far, newspaper advertisements and initial press releases were the most effective promotion methods, with fair cost-effectiveness that was equivalent to earlier online studies. These results can provide important suggestions for future promotions for the recruitment of presymptomatic participants to AD clinical trials in Japan.

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中文翻译：

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招募参与者参加阿尔茨海默病预防试验在线筛查登记处的推广方法的有效性和成本效益：观察性研究

背景：基于网络的筛查可能适用于识别有症状前潜在疾病的个体以招募到临床研究中，因为这些人在症状前阶段并不经常去医院。此类在线筛选研究的推广对其成功至关重要，但仍不确定此类推广的有效性会如何不同，具体取决于不同的推广方法、感兴趣的领域或实施国家。目标：日本试验就绪队列 (J-TRC) 网络研究是我们正在进行的在线筛查登记，用于识别症状前阿尔茨海默病 (AD) 患者，旨在促进 AD 预防的临床试验。在 2019 年推出的前 9 个月内，J-TRC 网络研究通过多种推广方式招募了数千名在线参与者，包括新闻稿、报纸广告、网络广告或直接电子邮件邀请。在这里，我们旨在定量评估每种多模式推广方法的功效和成本效益。方法：我们应用向量自回归模型来评估每种促销活动对以下目标指标的贡献程度：J-TRC 网站的每日访问者数量、J-TRC 网站研究的每日注册人数、每日访客注册率、注册者中合格参与者的每日比率以及每日注册者的中位年龄。还使用矢量-自回归模型中的总成本和系数计算每种促销方法的平均成本效益。结果：在2019年10月31日至2020年6月17日的回顾期内的前9个月，有48,334个网站访问者和4429个注册（48,334个访问者的9.16%），其中3081个（69.56%）是符合条件的注册。最初的新闻发布报告和报纸广告对增加每日访客和每日注册人数产生了显着影响。网络广告对每日访问量的增加有显着贡献（P <.001），但对每日注册人数没有影响，并且还降低了注册率和每日注册人的中位年龄。来自发送到其他认知注册机构的直接电子邮件邀请的网站访问者似乎以最高的可靠性进行了注册。初始新闻稿的计算平均成本效益为每位访客 24.60 美元和每位注册人 96.10 美元，而报纸广告的计算平均成本效益为 28 美元。每位访客 60 美元，每位注册人 227.90 美元。结论：我们的多变量时间序列分析表明，每种促销方法在招募 J-TRC 网络研究参与者的效果方面具有不同的特征。在目前的广告条件设置下，报纸广告和初始新闻发布是最有效的推广方式，具有与早期在线研究相当的成本效益。这些结果可以为未来在日本招募症状前参与者参加 AD 临床试验提供重要建议。在目前的广告条件设置下，报纸广告和初始新闻发布是最有效的推广方式，具有与早期在线研究相当的成本效益。这些结果可以为未来在日本招募症状前参与者参加 AD 临床试验提供重要建议。在目前的广告条件设置下，报纸广告和初始新闻发布是最有效的推广方式，具有与早期在线研究相当的成本效益。这些结果可以为未来在日本招募症状前参与者参加 AD 临床试验提供重要建议。

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