# Live guideline-concordance dashboards for every tumour board, generated from the record

Source: https://onco.cc/ideas/idea-acc-guideline-concordance-dashboards/  
OnCo record `idea-acc-guideline-concordance-dashboards` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Hospitals rarely know what fraction of their patients got the recommended treatment. Software reading the electronic record can show each team, every month, where care deviated from guidelines.

## Summary

Guideline adherence differs from hospital to hospital and is usually measured years later by registry studies. Structured oncology data (mCODE-style) and rule engines encoding guideline pathways make near-real-time concordance measurement possible. Each multidisciplinary team would see its own concordance by tumour type and stage, with justified deviations flagged separately from unjustified ones, and could compare against peers.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Teams receiving monthly concordance feedback will increase guideline-concordant treatment by at least ten percentage points within a year, with the largest gains in centres starting below the median.
- Rationale: Audit and feedback is among the best-evidenced quality interventions in medicine; the barrier in oncology has been the labour of abstraction, which structured data removes.
- Proposed test: A cluster-randomised trial of dashboards across 40 hospitals with registry-verified concordance and survival as endpoints.
- Maturity: early-clinical
- Actor: data

## Sources

- Bottleneck evidence (Fragmented care and guideline gaps): Hanna et al., Mortality due to cancer treatment delay: systematic review and meta-analysis (BMJ 2020): https://doi.org/10.1136/bmj.m4087

## Connected records

- collections: [ESMO Clinical Practice Guidelines & MCBS](https://onco.cc/collections/esmo-guidelines/), [NCCN Guidelines](https://onco.cc/collections/nccn/)
- fronts: [AI & Computation](https://onco.cc/fronts/ai-computation/)
- bottlenecks: [Data silos](https://onco.cc/bottlenecks/b-data-silos/), [Fragmented care and guideline gaps](https://onco.cc/bottlenecks/b-care-fragmentation/), [Knowledge reaches practice too slowly](https://onco.cc/bottlenecks/b-knowledge-diffusion/)
- key papers: [Mortality due to cancer treatment delay: systematic review and meta-analysis](https://onco.cc/key-papers/paper-hanna-bmj/)
- ideas: [Audit whether tumour board recommendations were actually carried out](https://onco.cc/ideas/idea-acc-tumour-board-implementation-audit/)

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