Publish the disagreement between trial doctors and independent reviewers for every trial
Trials often have independent radiologists check whether tumours grew. How often they disagree with the treating doctors is a measure of how trustworthy the result is, and it is rarely published.
Blinded independent central review (BICR) is standard for progression-free survival in registrational trials, and discordance with investigator assessment is common. Regulators see the discordance data; the public usually does not. Requiring publication of the discordance rate, its direction by arm, and the sensitivity analysis in every trial report would let readers assess bias, and would create a dataset on when BICR matters and when it can be dropped to save cost.
- Biomarkers are not validated or standardised · Tests that decide who gets a drug are often not validated prospectively and are measured differently in every lab.
- 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.
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not linked directly; found by shared links- IdeaValidate real-world progression endpoints so pragmatic trials can use them
Shares RECIST, Progression-free survival (PFS), Biomarkers are not validated or standardised, Trial design, endpoints and cost.
- IdeaAutomatically detect when a trial changes its outcomes after the fact
Shares Run automated statistics and image checks on every cancer manuscript before review, Trial design, endpoints and cost.
- IdeaMake clonal clearance, not tumour shrinkage, a trial endpoint
Shares RECIST, Progression-free survival (PFS), Trial design, endpoints and cost.
- IdeaBayesian shrinkage for subgroup claims to stop false 'works in this group' stories
- IdeaAI-assisted central imaging reads to cut endpoint cost and variability
Shares RECIST, Progression-free survival (PFS), Trial design, endpoints and cost.
- IdeaPre-specified crossover-adjusted survival in every trial that allows crossover
- IdeaSeamless phase 2/3 with pre-registered go rules as the default for new agents
Shares Progression-free survival (PFS), Trial design, endpoints and cost.
- IdeaValidate real-world progression against central imaging review
Shares RECIST, Progression-free survival (PFS).