ideasIdea
A mandatory trial line in every tumour board recommendation
Every time a team of specialists meets to plan a patient's treatment, they would have to record whether a trial exists for that patient and, if so, why it was or was not offered.
Multidisciplinary tumour boards and molecular tumour boards add a required structured field to their recommendation: matched trials considered (with identifiers), offered yes/no, and reason if not. A trial coordinator pre-populates the field from a matching tool before the meeting. The field is auditable and the offer rate reported quarterly by service.
Hypothesis
Making trial consideration a documented step raises the trial offer rate from the typical single digits to over 20 percent of board-discussed patients within a year, and enrolment rises in proportion.
Rationale
Checklists change behaviour where the omission is habitual rather than deliberate. Surgical safety checklists and the 'sepsis six' work through the same mechanism. Tumour boards already have the structure; only the field is missing.
What would test it
Before-after with contemporaneous control services in two cancer centres; outcome is documented trial offers and enrolments per 100 board discussions.
Maturity
speculative
Who has to act
clinic
Cost to try
Small (under $1M)
Years to first evidence
1
Bottlenecks it attacks
- 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.