How to incentivize study participation while avoiding fraud.

It’s a Catch-22. Research studies often pay participants for their time and involvement, but that payment can be a magnet, attracting people who don’t actually qualify. Without the proper controls in place, your study could end up with inaccurate data, affecting your research and reputation. It can affect what you do with that data, whether that’s publishing or validating a solution. 

It’s possible to avoid the bias and misdirection introduced by including the wrong participants if you’re aware of what to look for and how to design a better qualification system. It takes some work and forethought, which starts with the prescreening questions, and ultimately ends with analyzing the responses from potential participants. 


Designing an anti-fraud screener: verifying identity, offering payment

Scammers are primarily interested in making money, and making it quickly. They don’t care if their responses mess up your study. They are looking at their pocket. They also don’t want to spend more time than necessary to get through the screening or the study, so a little more work on your end on screening design can make a big difference in the outcome. 


Let prospects know that you are monitoring for fraudulent behavior.

Let prospects know you’re paying attention to the validity of the screening answers, as it can make a difference. Telling someone not to lie or use false information is one thing; it’s not very effective without a repercussion. That’s why some investigators take it a step further, putting a question into the screener directly asking participants to commit to not using false information. Pair this with telling them that if the sponsors detect fraudulent behavior, they will not receive compensation


Use delayed payments.

Delaying payment is another technique for staving off scammers who want money quickly. Telling the prospects that payment will be delayed a day to even a week can help sift through those who are responding for the right reasons with those in search of quick cash. 


Withhold compensation amounts till after eligibility assessment.

If it’s possible to share compensation amounts after a person meets the eligibility criteria, that is another good option. You do this by mentioning at the beginning that compensation amounts and delivery information will be shared at the end of the screening if the person qualifies for the study. Those coming for the quick payout may be dissuaded from wasting their time on the survey questions, though it’s possible that legitimate participants may also hesitate in responding, as a result.


Require identity verification.

Requiring users to verify their identity is another technique to get past fraud. This can include an SMS verification in order to confirm they are who they say they are. Telling prospects that identity verification will be required, and then following through, should decrease the number of these problematic responses. In addition to SMS messaging, verification can also be done with digital filters, mapping phone numbers to physical addresses, time zones and IP addresses. Of course, you’ll need to be aware that these days, cell phone numbers may not always match the area code’s location or time zone. 


Call or email perceived fraudulent responses.

Consider calling those who meet eligibility or those that appear fraudulent. Calling people takes time and they may not answer, but even voicemails can help weed out those who offered fraudulent information. Don’t second guess yourself when cutting people from participating. One study contacted people they eliminated from the study based on perceived fraudulent responses. The researchers used the contact information provided by participants and found that none of the people eliminated could actually be reached.


Crafting creative questions for an anti-fraud screener


Ask questions that are difficult to scam convincingly.

Scammers may not fully pay attention to the questions asked. They may push through as quickly as possible, not maintaining consistency. Ask for just enough detail to make the participant think, and even research the answer. For example, if you’re looking for specifics of their medication use, ask for prescription information. They may need to get the bottle to find out the details. Of course, a scammer can use the internet to find an answer, but there’s a better chance that they’ll make a mistake, especially for something specific like a medication or diagnosis. Also, someone with fraudulent intent may decide it’s not worth the time.


Include some questions that are used purely to spot fraudsters.

To further filter out the folks you don’t want, build in some distraction questions to the screening process. Consider asking the same question twice and compare the answers, like their age and their birth date. Ask them a question where they can pick all that apply, but make it so that answering more than one option would be unlikely. If they choose multiple answers, they may be trying harder to qualify, versus answering honestly. You can also ask a question that requires a simple answer, but people not paying attention will get it wrong. 


Measure time to completion and look for outliers.

Know the approximate length of time to complete the screener. Test it out on a few people with a timer. Then track how long participants take. Any outliers, like someone who fills it out in 2 minutes instead of the usual 8 minutes, merits a closer look. It’s possible they’re going through quickly to click, rather than read. Or determine a cutoff point for the minimum time to answer the survey, and those who fall below it are eliminated.


Limit social media advertising.

When reaching out to prospective participants, avoid advertising on social media when possible. While social media has a huge reach, it also tends to draw in people who are scanning for quick and easy money. Instead, limit the outreach to vetted organizations and moderated groups on specific and related topics. While you can’t control what happens after the information is out there, you can still ask people not to share the survey on social media.


No screening method is perfect.

Of course, no screening method is perfect. None of these individual ideas are enough on their own to ensure a perfect assessment. And it will be a lot of work to cull through the responses to look for variations, duplicated answers, and inconsistent responses. And know that putting up stumbling blocks in a screener, to weed out the fraudsters, can also eliminate some valid participants not willing to go through the extra effort, those with a less sophisticated understanding of technology, and people who may not speak English well. Also, the Institutional Review Board (IRB) may not approve every element of your plan, such as your survey capturing and using digital identification techniques.

If nothing else, though, you should now have a better awareness of some of the ways to avoid fraud in your studies, to attract a more genuine match for the research you’re doing. 


Let Pattern Health do the heavy lifting

To learn more about how your academic medical center or healthcare organization can benefit from a digital health platform for your study, contact Pattern Health. 



Written by: Matthew Hoyle