New Research Reveals Where Smarter COA Planning Pays Off
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Clinical Outcome Assessments (COAs) are essential for translating patient experiences into meaningful trial data, but they also bring complexity that creates friction.
A new research report, “Unlocking the Power of COAs in Clinical Research,” found that early and strategic planning can help address the top three COA friction points: licensing, translations, and rater training.
In this blog, we share findings on where the greatest opportunities lie — and why planning earlier and partnering smarter are keys to stronger trial execution.
Overcoming Licensing Friction
One of the first hurdles in COA execution is licensing: who owns the scale, which permissions are needed, and how long it will take to secure them. Survey data found that 65% of clinical researchers cited slow licensing turnaround as a top operational challenge, compounded by unclear ownership, usage terms, and unexpected costs.
This is where proactive engagement is key. Starting earlier gives teams more runway to navigate licensing complexities before they become bottlenecks. Working with expert support, teams can identify copyright holders and clarify licensing requirements up front, including protocol-specific details, to avoid delays.
According to Lynsey Psimas, Ph.D., director of business development for Pearson Clinical Assessments Pharmaceutical team, “Early engagement isn’t just about saving time. It is about safeguarding scientific integrity. When licensing and translation timelines are managed early, teams can focus on data quality rather than paperwork.”
Bridging Translation Gaps
Global trials depend on accurate translations, but confidence is far from guaranteed. Fewer than half (44%) of researchers were “very confident” in translations, while 64% cited quality concerns, and 63% said regulatory acceptance was the top challenge.
The risks are significant: retranslation, regulatory pushback, poor data quality, or even restarting a study.
“We see this becoming an even greater issue in CNS and rare-disease trials, where even small shifts can affect the results,” Psimas noted. “With such high stakes, COA translations must be implemented with rigor and care.”
Standardized workflows and early collaboration with a trusted Language Service Provider (LSP) can reduce these risks. Working with an experienced LSP helps ensure translations meet cultural, linguistic, and regulatory standards from the start.
Solving Rater-Training Challenges
COAs are only as strong as the people applying them. When raters lack consistent training, performance suffers, and the result can be unreliable data, higher costs, and delays.
It’s a complex challenge for researchers: 52% struggled to track who had completed training, while others cited gaps in multilingual modules and recertification. Many wanted access to expert trainers (45%), centralized tracking (42%), and budget-friendly global options (40%).
“This suggests that effective training must extend beyond simply having the right materials. It requires a holistic approach, integrating various platforms and systems with human expertise to manage training across languages and cultures,” Psimas added.
Scalable, consistent training with expert guidance can improve data quality and validity. This is especially important in global studies where training may need to be translated and culturally adapted for different locations.
Planning Earlier, Partnering Smarter
Too often, COAs are delayed or disconnected from the overall strategy. By planning earlier and partnering smarter, clinical trial teams can transform common friction points into a smoother experience.
To learn more about COA benchmarking, download the report, “Unlocking the Power of COAs in Clinical Research.”