# Publish why patients were screened out of each trial

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

## TL;DR

Trials record why each screened patient did not join, but that data is never shared. Publishing it would show which rules block the most people and which are pointless.

## Summary

Sponsors report, per trial, the number screened, the number enrolled and screen-failure reasons in a standard coded vocabulary (specific criterion, patient declined, logistics) to the trial registry at completion. Aggregate analysis identifies criteria that exclude many patients across trials with no safety justification and informs eligibility reform.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Public screen-failure reporting will identify a small set of criteria responsible for the majority of exclusions in each disease and lead to their removal in subsequent protocols, increasing eligible fractions.
- Rationale: Eligibility reform currently relies on simulations against real-world data; actual screen-failure data is the ground truth and already collected on screening logs. Making it visible creates pressure to fix the worst criteria.
- Proposed test: A registry pilots a screen-failure data field for oncology trials; after two years, analyse which criteria dominate and whether protocols from participating sponsors changed.
- Maturity: speculative
- Actor: regulator

## 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/), [EU Clinical Trials Register / CTIS](https://onco.cc/collections/eudract-ctis/)
- bottlenecks: [Trial design, endpoints and cost](https://onco.cc/bottlenecks/b-trial-design/), [Trials enrol too few, too slowly](https://onco.cc/bottlenecks/b-trial-enrolment/)

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