{"entity":{"id":"idea-data-point-of-care-randomisation","kind":"idea","name":"Point-of-care randomisation built into the oncology record","aka":[],"tldr":"When two accepted treatments are equally reasonable, the computer system would offer to randomise the choice and track the result, turning ordinary care into a continuous trial.","summary":"Learning health systems embed randomisation into workflow where genuine equipoise exists (dose schedules, supportive care, sequencing). The US Veterans Affairs system and the NHS have run point-of-care trials; oncology has few. The proposal builds a reusable EHR module (consent, randomisation, outcome capture via registry linkage) so that any cancer network can run a low-cost comparative effectiveness trial in weeks.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Data silos): AACR Project GENIE","url":"https://www.aacr.org/professionals/research/aacr-project-genie/"}],"tags":[],"related":[],"cancers":[],"sections":["ai-computation"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["real-world-evidence"],"trials":[],"people":[],"bottlenecks":["b-data-silos","b-trial-design","b-trial-enrolment"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Embedded randomisation will enrol more than ten times as many patients per year as conventional comparative effectiveness trials at less than a tenth of the per-patient cost.","rationale":"Registry-based randomised trials in cardiology (TASTE, SWEDEHEART) enrolled thousands at roughly 50 dollars per patient; the design transfers to questions with routine outcomes.","test":"Run one embedded trial (for example, two accepted anti-emetic regimens or two follow-up imaging schedules) in one network; measure enrolment rate, cost and completeness of outcome capture.","maturity":"early-clinical","actor":"clinic","cost":"medium","horizonYears":3},"route":"/ideas/idea-data-point-of-care-randomisation/","neighbours":{"section":[{"id":"ai-computation","kind":"section","name":"AI & Computation","route":"/fronts/ai-computation/"}],"term":[{"id":"real-world-evidence","kind":"term","name":"Real-world evidence","route":"/terms/real-world-evidence/"}],"bottleneck":[{"id":"b-data-silos","kind":"bottleneck","name":"Data silos","route":"/bottlenecks/b-data-silos/"},{"id":"b-trial-design","kind":"bottleneck","name":"Trial design, endpoints and cost","route":"/bottlenecks/b-trial-design/"},{"id":"b-trial-enrolment","kind":"bottleneck","name":"Trials enrol too few, too slowly","route":"/bottlenecks/b-trial-enrolment/"}]}}