# Guidelines list the open trials at every decision point, updated monthly

Source: https://onco.cc/ideas/idea-tr1-open-trials-inside-guidelines/  
OnCo record `idea-tr1-open-trials-inside-guidelines` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Treatment guidelines tell doctors what to do at each step but rarely which trials are open for that step. Adding a live, monthly-updated list to each decision node would put trials where doctors look.

## Summary

NCCN, ESMO and national guidelines add a machine-updated 'open trials for this node' panel to each algorithm step, generated from registry data filtered by setting and line of therapy, with a link to slot availability. The static 'clinical trial participation is encouraged' footnote becomes actionable.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Decision nodes with trial panels will have higher referral rates to the listed trials than nodes without, measured via referral-source tracking at trial sites.
- Rationale: Guidelines are the most consulted documents in oncology practice; embedding trials there reaches every clinician without new software.
- Proposed test: One guideline body pilots panels for two cancers; sites of listed trials record referral source for a year.
- Maturity: speculative
- Actor: research

## Sources

- Bottleneck evidence (Trials enrol too few, too slowly): Unger et al., Systematic review of barriers to cancer trial participation (JNCI 2019): https://doi.org/10.1093/jnci/djy221

## Connected records

- collections: [ClinicalTrials.gov](https://onco.cc/collections/clinicaltrials-gov/), [ESMO Clinical Practice Guidelines & MCBS](https://onco.cc/collections/esmo-guidelines/), [NCCN Guidelines](https://onco.cc/collections/nccn/)
- institutions: [European Society for Medical Oncology (ESMO)](https://onco.cc/institutions/esmo/)
- bottlenecks: [Knowledge reaches practice too slowly](https://onco.cc/bottlenecks/b-knowledge-diffusion/), [Trials enrol too few, too slowly](https://onco.cc/bottlenecks/b-trial-enrolment/)

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