Point-of-care randomisation built into the oncology record
When two accepted treatments are equally reasonable, the computer system would offer to randomise the choice and track the result, turning ordinary care into a continuous trial.
Learning health systems embed randomisation into workflow where genuine equipoise exists (dose schedules, supportive care, sequencing). The US Veterans Affairs system and the NHS have run point-of-care trials; oncology has few. The proposal builds a reusable EHR module (consent, randomisation, outcome capture via registry linkage) so that any cancer network can run a low-cost comparative effectiveness trial in weeks.
- Data silos · Records, scans, genomes and outcomes sit in separate systems that cannot talk. Every patient's experience is lost to the next.
- Trial design, endpoints and cost · A phase 3 trial takes years and hundreds of millions of dollars, and often answers a question that has already moved on.
- Trials enrol too few, too slowly · Fewer than one in ten adults with cancer joins a trial. Trials close for lack of patients, not lack of ideas.
Pages like this
not linked directly; found by shared links- IdeaRegistry-based randomised trials for oncology comparative effectiveness
Shares Trials enrol too few, too slowly, Real-world evidence, Trial design, endpoints and cost.
- IdeaNo mCODE, no payment: tie oncology reimbursement to a minimal structured record
Shares Real-world evidence, Data silos.
- IdeaAccredited trusted research environments with curated cancer tables
Shares Real-world evidence, Data silos.
- IdeaDirect record-to-database data capture: no manual transcription, no full source verification
- IdeaOpen, benchmarked algorithms for lines of therapy and progression from routine data
Shares Real-world evidence, Data silos.
- IdeaSimulate eligibility against real-world data before every protocol is locked
Shares Trials enrol too few, too slowly, Real-world evidence.
- IdeaAutomatic weekly linkage of cancer registries to deaths, prescriptions and imaging
Shares Real-world evidence, Data silos.
- IdeaPragmatic trials in patients over 75 with function, not just survival, as the primary endpoint
Shares Trials enrol too few, too slowly, Trial design, endpoints and cost.