Accountable Research Organization

Engineered to give you confidence and control over your infectious diseases clinical study

Infectious diseases trials are won and lost before eligibility windows close.

Narrow eligibility windows, standard-of-care initiation that eliminates candidates before sites are alerted, and acute presentation settings without research infrastructure create a system where eligible patients disappear before enrollment can begin.

Lindus integrates prospective identification of high-risk populations before acute presentation, rapid consent workflows, and decentralized delivery into a single operating model built for time-sensitive enrollment.

Challenges and strategies in infectious diseases trials

Enrollment success is engineered, not left to chance

Influenza treatment RSV treatment Prophylactics and vaccines

Obesity

Challenge

Lindus approach

Strict onset windows driving screen failures

Challenge

Influenza trials require laboratory confirmation within narrow symptom-onset timeframes, but patients delay care until symptoms escalate. By the time central lab results confirm eligibility, many candidates have aged out of the protocol window. Sites screen large volumes only to exclude patients on elapsed timing: stalling enrollment velocity during unpredictable seasonal waves.

Lindus approach

Lindus deploys direct-to-patient outreach during viral season to pre-educate high-risk populations to present at first symptoms. Patient concierge coordinators compress the identification-to-site interval with rapid scheduling and transport. AI-assisted screening pre-filters candidates on EHR diagnosis codes and visit timing before site coordinators invest in manual eligibility review.

Vulnerable populations presenting atypically

Challenge

Elderly patients present with delirium, falls, or cardiovascular events rather than classic respiratory symptoms. Viral etiology is recognized only after standard workup: by which time the eligibility window has often closed. Proxy consent requirements add administrative delay in settings already compressed by acute clinical demands.

Lindus approach

Lindus pre-identifies elderly high-risk patients through EHR comorbidity records and establishes contact with legally authorized representatives before acute admission. Patient concierge coordinators manage LAR coordination and rapid scheduling to compress recognition-to-randomization, while eConsent enables remote digital authorization eliminating paper-based delays during the medical emergency.

Standard care initiation eliminating treatment-naive candidates

Challenge

Clinical guidelines mandate immediate antiviral initiation for high-risk hospitalized patients upon clinical suspicion: before laboratory confirmation arrives. Protocol requirements for diagnostic confirmation prior to dosing conflict directly with this standard, and prior-treatment exclusions eliminate most high-risk candidates before any site contact. Screen failure rates are structurally elevated.

Lindus approach

Lindus queries EHR records by diagnosis codes and medication history to surface patients presenting with confirmed influenza who have not yet initiated antiviral therapy: the brief treatment-naive window before standard care begins. Patient concierge compresses scheduling and site coordination to preserve that window before standard-of-care initiation eliminates eligibility.

Narrow eligibility window and diagnostic delays

Challenge

RSV protocols require virological confirmation within tight symptom-onset windows, but standard outpatient settings rarely use rapid molecular panels. Care-seeking delay, confirmation lag, and screening administration time converge to exhaust the eligibility clock before randomization occurs. Sites resource continuously for peak-readiness but generate disproportionately low enrollment yields.

Lindus approach

Lindus pre-identifies high-risk patients through EHR records and deploys direct-to-patient outreach reaching symptomatic individuals before clinic presentation. AI-assisted screening pre-filters on documented diagnosis codes and onset timing before site coordinators intervene. Feasibility assessment stress-tests your confirmation window against real-world care-seeking intervals before activation.

Atypical presentations obscuring older adults

Challenge

Older adults present with confusion, falls, or cardiovascular decompensation rather than respiratory symptoms, routing them into neurology and cardiology workflows where respiratory screening is absent. Traditional infectious disease referral networks miss this population entirely, and by the time RSV is suspected the eligibility window has often closed.

Lindus approach

Lindus queries non-respiratory EHR signals: confusion episodes, falls, cardiovascular events, inflammatory markers, cross-referenced with age and comorbidity profiles to surface older adults misrouted outside respiratory channels. AI-assisted screening pre-qualifies on documented clinical data, and patient concierge coordinates proxy consent with legally authorized representatives before the acute enrollment window expires.

Caregiver exhaustion disrupting pediatric data collection

Challenge

Infant RSV trials require caregivers who have just managed intensive acute hospitalization to maintain daily symptom diaries and attend follow-up visits post-discharge. Physical and emotional exhaustion drives progressive dropout degrading time-to-resolution endpoint evaluability. Missing diary entries invalidate entire collection cycles, and high attrition forces over-enrollment that extends timelines.

Lindus approach

Citrus ePRO/eCOA deploys automated reminders calibrated to your time-to-resolution endpoints, sustaining caregiver diary completion through post-discharge fatigue. Patient concierge coordinators arrange transport, childcare, and stipend disbursement: eliminating the logistical friction that converts exhausted parents' intention to participate into actual withdrawal from your trial.

Shrinking naive and seronegative pools

Challenge

Expanding standard-of-care coverage and endemic exposure continuously erode the pool of pathogen-naive participants. Broad serological screening generates elevated screen failure rates as hidden prior exposure disqualifies candidates after blood draws are ordered. The rising screen-to-randomization ratio inflates per-patient costs and extends timelines across the program.

Lindus approach

Lindus queries vaccination histories, prior infection codes, and longitudinal lab values across 40M+ EHR records to exclude likely seropositive candidates before a single assay is ordered. AI-assisted screening automates naivety adjudication against your protocol criteria, so sites run confirmatory serology on a pre-vetted cohort enriched for naive status.

Healthy cohort surveillance fatigue

Challenge

Prophylactic trials ask healthy individuals to sustain diary logging, repeated swabbing, and periodic monitoring for a theoretical future benefit offering no immediate symptom relief. Without intrinsic motivation of treating active disease, tolerance for this asymmetrical commitment is low. Progressive non-compliance degrades data completeness and leaves primary efficacy events unrecorded.

Lindus approach

Citrus ePRO/eCOA deploys automated surveillance-specific reminders for diaries, swab windows, and serology visits maintaining healthy-volunteer adherence across multi-season follow-up. Patient concierge coordinators manage scheduling, transport, and stipend disbursement: addressing the motivational deficit that accumulates when trial participation competes with normal daily life without symptomatic benefit.

Acute post-exposure enrollment in emergency settings

Challenge

Post-exposure prophylaxis trials require rapid consent and immediate dosing in emergency departments following unpredictable acute trauma. Emergency staff unfamiliar with research coordination create logistical friction delaying the first dose. Once acute fear subsides post-discharge, patients frequently skip subsequent doses, creating protocol deviations and missing primary endpoint data.

Lindus approach

Site augmentation deploys virtual nurses and coordinators into emergency departments during exposure events, executing eConsent digitally so triage staff remain focused on clinical care. Patient concierge maintains post-discharge contact with each participant: coordinating transport and scheduling for every follow-up dose to prevent attrition that peaks once post-trauma urgency fades.

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