# Real-time guideline-concordance feedback for every cancer centre

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

## TL;DR

Show each hospital, every month, how often its patients received the recommended treatment, compared with peers, so gaps are seen and closed.

## Summary

Audit and feedback is one of the best-evidenced ways to change clinical practice, but oncology audits are infrequent and slow. Using structured data (mCODE) and computable guidelines, concordance for key decisions (biomarker testing before first-line therapy, adjuvant therapy in eligible patients, guideline-recommended regimens) can be computed monthly per centre and fed back with peer comparison. Precedents include ASCO's QOPI and the Dutch cancer audits (DICA).

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Monthly automated feedback will close the gap between actual and recommended care for measured decisions by at least half within two years, particularly for biomarker testing rates.
- Rationale: Cochrane reviews find audit and feedback improves adherence by a median of several percentage points, more when frequent and with peer comparison; automation removes the cost barrier to frequency.
- Proposed test: Randomise 40 centres to monthly automated feedback or annual audit; measure biomarker testing and guideline-concordant first-line therapy rates at 18 months.
- Maturity: early-clinical
- Actor: clinic

## Sources

- Bottleneck evidence (Knowledge reaches practice too slowly): Morris, Wooding & Grant, The answer is 17 years, what is the question (JRSM 2011): https://doi.org/10.1258/jrsm.2011.110180

## Connected records

- ideas: [Living guidelines published as versioned, computable rules](https://onco.cc/ideas/idea-data-computable-living-guidelines/), [Update hospital order sets within 30 days of a guideline change](https://onco.cc/ideas/idea-data-order-set-defaults-30-days/)
- fronts: [AI & Computation](https://onco.cc/fronts/ai-computation/)
- institutions: [American Society of Clinical Oncology (ASCO)](https://onco.cc/institutions/asco/)
- bottlenecks: [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: [The answer is 17 years, what is the question: understanding time lags in translational research](https://onco.cc/key-papers/paper-morris-j-r-soc-med/)

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