# Offline decision support for generalists treating common cancers in low-resource settings

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

## TL;DR

A phone app that works without internet and guides a general doctor or nurse through diagnosing and treating common cancers with the drugs actually available locally.

## Summary

In much of the world cancer is treated by generalists with no oncologist within reach. Resource-stratified guidelines (NCCN Harmonized Guidelines for sub-Saharan Africa, ASCO resource-stratified guidelines, WHO essential medicines) exist as documents. Encoding them as offline-capable, computable decision support with local formulary awareness, dose calculators and referral criteria, endorsed by WHO and ministries, would put them at the point of care.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Generalists using offline decision support will deliver guideline-concordant treatment in a substantially higher share of cases and reduce serious dosing errors versus usual practice.
- Rationale: Offline clinical decision support for HIV and maternal health improved adherence to protocols in LMIC trials; cancer guidance is more complex but the delivery mechanism is proven.
- Proposed test: Cluster-randomise 20 district hospitals in two countries to the app or usual care for breast and cervical cancer; measure concordance and dosing errors over 12 months.
- Maturity: early-clinical
- Actor: philanthropy

## Sources

- NCCN Harmonized Guidelines for Sub-Saharan Africa: https://www.nccn.org/global/what-we-do/harmonized-guidelines

## Connected records

- fronts: [AI & Computation](https://onco.cc/fronts/ai-computation/)
- collections: [NCCN Guidelines](https://onco.cc/collections/nccn/)
- institutions: [American Society of Clinical Oncology (ASCO)](https://onco.cc/institutions/asco/)
- bottlenecks: [Knowledge reaches practice too slowly](https://onco.cc/bottlenecks/b-knowledge-diffusion/), [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Not enough oncologists, nurses, pathologists, physicists](https://onco.cc/bottlenecks/b-workforce/)

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