Innovation in Action: What a High-Performing Decentralized Phase 3 Trial Can Teach Us

At SCOPE 2026, leaders from Praxis Precision Medicines and Spectrum Science Clinical led a panel and shared behind-the-scenes learnings from Essential 3—a fully decentralized Phase 3 trial in adults with essential tremor (ET) that is redefining what’s possible in clinical trial performance.

The trial not only met its primary endpoint, it enrolled nearly five times faster than recent ET trials and is among the first decentralized Phase 3 studies designed to support FDA submission. 

For those navigating recruitment complexity, decentralization and rising patient expectations, here are the key takeaways.

Solve for patients—and speed follows 

Decentralization wasn’t chosen for novelty. As Praxis COO Megan Sniecinski shared, the goal was simple but urgent: solve for time for patients. ET is an underserved condition with a significant impact on daily life. Designing the trial to minimize burden—and bring it to patients—allowed the team to move faster without sacrificing data quality. 

Alignment early is everything 

Success started long before enrollment. Early alignment across sponsor, CRO and vendors created a shared game plan of clearly defined roles, centralized data and a mapped end-to-end patient journey. That foundation enabled faster decisions and fewer downstream surprises. As Spectrum Group SVP Sara Root noted, the team embraced adaptability from the start, knowing they would need to pivot as real-world conditions emerged. 

Agility requires data—and the courage to use it 

Innovation means accepting that not everything will work the first time. 

Praxis Senior Director Taylor Crush emphasized the importance of “failing fast and learning,” supported by real-time data and technology that provided visibility across the entire patient journey. That visibility proved critical. As Spectrum EVP Paul Ivsin shared, having clear insight into every stage of enrollment—including pre-consent activity—allowed the team to identify bottlenecks early and redirect resources before momentum was lost. 

Bringing trials to patients works

From home visits to flexible locations that fit patients’ lives, decentralization wasn’t a barrier—it was a differentiator. Patients embraced the flexibility, and the feedback was overwhelmingly positive. The result: higher engagement, faster enrollment and a model that respected patients’ time and realities. 

The takeaway 

The Essential 3 trial demonstrated what’s possible when patient-first design, cross-functional alignment and operational agility come together—powered by transparent data and the right partners. 

For sponsors considering decentralized or hybrid approaches, the message was clear: Be brave. Challenge what’s comfortable. And design trials that move at the pace patients deserve. 

Want to learn more? Spectrum Science Clinical partners with sponsors to deliver precision recruitment and engagement through integrated strategy, proprietary technology, and adaptive solutions—helping accelerate enrollment across individual trials or entire R&D pipelines.