A public registry of unanswered clinical questions linked to funding calls
Keep a public list of the questions doctors and patients most need answered but no trial addresses, and tie research funding to it.
Guideline panels repeatedly note evidence gaps but the gaps are buried in documents. The James Lind Alliance sets priorities with patients and clinicians but has limited oncology coverage. The proposal creates a structured, open registry of evidence gaps extracted from computable guidelines and living reviews, prioritised by burden and patient input, with funders committing to reference it in calls and trialists to register which gap a trial addresses.
- Knowledge reaches practice too slowly · Knowledge diffusion is slow: it takes years for a proven result to change what most patients receive, and no one can keep up with the literature.
- Funding follows fashion, not burden · Money goes to the cancers and questions that are easy or popular, not the ones that kill most or where a dollar would do most.
- Patients lack understanding, navigation and agency · Most patients cannot understand their options, find trials, or push back, so decisions are made for them.
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