OnCo
ideasIdea

Publish each laboratory's biomarker proficiency results

Labs already get tested on whether they score biomarkers correctly, but the results are private. Publishing them would let hospitals and patients avoid labs that get it wrong.

External quality assessment schemes (NordiQC, UK NEQAS, CAP) show that a meaningful fraction of laboratories fail proficiency runs for HER2, PD-L1, ALK and other predictive markers. Results are confidential. Mandatory participation for any laboratory running companion diagnostics and public reporting of pass rates by laboratory, as is done for hospital infection rates, would create accountability and steer referrals.

Hypothesis
Public reporting will raise the proportion of laboratories passing predictive-marker EQA runs above 95% within three years, and reduce the between-laboratory variation in positivity rates.
Rationale
Public performance reporting improved outcomes in cardiac surgery and hospital-acquired infections. Laboratory medicine has the data and has resisted transparency.
What would test it
Publish results for one marker in one country; measure pass rates and referral shifts over two years.
Maturity
early clinical
Who has to act
regulator
Cost to try
Small (under $1M)
Years to first evidence
2
Bottlenecks it attacks

Connected

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Pages like this

not linked directly; found by shared links

technologies

2
Companion diagnosticsHistopathology & immunohistochemistry

ideas

3
Calibrated reference slides so every lab scores HER2-low the same wayMonitor biomarker positivity rates across labs in real time to catch assay driftRecord how long tissue waited before fixation in every pathology report

bottlenecks

2
Biomarkers are not validated or standardisedFragmented care and guideline gaps