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This trend was further expedited by the global COVID\u201019 pandemic. We identified 23 case studies across various therapeutic areas and grouped them into different categories according to their purposes\u2014by necessity, for operational benefits, to address unique research questions, to validate innovative digital endpoints, or to validate decentralization as a clinical research platform. We leveraged the estimand framework from ICH E9(R1) including its five attributes (population, treatment, variable, intercurrent event, and summary measure) to critically assess their design and conduct. Common trends, opportunities, and challenges were reported along with recommendations for future DCT. Of note, intercurrent events and associated handling strategies are largely not present when reporting DCT. This is an area that can impact study conclusions and require more dedicated efforts when designing new DCTs.<\/jats:p>","DOI":"10.1111\/cts.70328","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T15:21:48Z","timestamp":1757344908000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Decentralized Clinical Trials in the Era of Real\u2010World Evidence: A Critical Assessment of Recent Experiences"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1211-1966","authenticated-orcid":false,"given":"Hongwei","family":"Wang","sequence":"first","affiliation":[{"name":"Data and Statistical Sciences AbbVie  North Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4136-4068","authenticated-orcid":false,"given":"Nadia","family":"Daizadeh","sequence":"additional","affiliation":[{"name":"Advanced 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