Multi-centre trials provide key evidence underpinning healthcare practice. However, they invariably take a lot of hard work and expense to complete, with some of this work and expense being devoted to sites that under-recruit. Developing practical methods to identify sites that will recruit to target would be helpful.

ESP2 aims to evaluate a guided site performance prediction tool for trial managers. The tool was developed during the initial ESP study using practical experience from trial managers. Trial managers were asked to identify reasons why sites might fail to recruit to target in randomised and non-randomised interventional trials.

ESP identified eight possible 'red flags' to predict recruitment failure at a site:

  • previous poor site performance
  • slow approvals process
  • strong staff/patient preferences
  • the site recruitment target
  • the trial protocol and its implementation at the site
  • lack of staff engagement
  • lack of research experience among site staff; busy site staff.

We have used these identified flags to develop a site performance prediction tool. We hope that using this tool will improve the accuracy of trial managers’ predictions about site recruitment performance, but this needs evaluation. It is this evaluation that ESP2 will conduct.

To evaluate the tool, we need trial managers to make 1000 site performance predictions (will the site recruit to target yes or no?). We invite trial managers working in anywhere in the world to register and start making predictions! If you’d like more information, scroll down.

ESP2 is a collaboration between University of Aberdeen, Trial Forge and the UK Trial Managers' Network.

For more information please see -


Hanne Bruhn;

Shaun Treweek;




Bruhn et al. Trials (2019) 20:192