# Patients are told which trials they qualify for at every treatment decision, in writing

Source: https://onco.cc/ideas/idea-moon-trial-eligibility-at-every-decision/  
OnCo record `idea-moon-trial-eligibility-at-every-decision` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

At each point where treatment is chosen, software checks the patient's record against open trials and the clinician must note which were discussed, so trials stop being something only some people hear about.

## Summary

Fewer than one in ten adults with cancer enter trials, partly because eligibility is never checked. Structured records (mCODE) and trial registries with structured eligibility now allow automated pre-screening. The proposal is a documented eligibility check at each decision point, including trials at other centres, with the result shown to the patient in plain language and a referral pathway funded by the payer.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Documented matching raises trial discussion rates to over 80% of decision points and doubles enrolment, with proportionally larger gains for minority and community patients.
- Rationale: Trial offer is the single strongest determinant of enrolment; inequity in offer, not refusal, explains much under-representation.
- Proposed test: Cluster-randomised implementation in community oncology practices with matching software; endpoints trial discussion documentation, referral and enrolment by demographic group.
- Maturity: early-clinical
- Actor: engineering

## Sources

- Bottleneck evidence (Patients lack understanding, navigation and agency): Basch et al., Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment (JAMA 2017): https://doi.org/10.1001/jama.2017.7156

## Connected records

- technologies: [AI trial matching & clinical decision support](https://onco.cc/technologies/ai-trial-matching/)
- bottlenecks: [Patients lack understanding, navigation and agency](https://onco.cc/bottlenecks/b-patient-voice/), [Trials enrol too few, too slowly](https://onco.cc/bottlenecks/b-trial-enrolment/)

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