Ensure every patient can participate in clinical trials for the most promising treatments
This is how your doctor's visit should actually work, with a global, open treatment evidence network.
- Treatment rankings based on real-world outcomes
- An Outcome Label for every treatment
- Patient data that stays with patients and their clinics
Every patient helps the next
- 1
Compare
You and your doctor see which treatments worked for people like you.
- 2
Join
You start one as part of your normal care, in a pragmatic trial.
- 3
Report
You record how you feel, and your health records add the rest.
- 4
Improve
Your results update the rankings and Outcome Labels for the next patient.
Then the next patient starts at step 1, with better evidence.
Care-integrated clinical trials, explained in two minutes
Comparative Effectiveness Rankings
Patients and doctors would see which treatments worked best for people with the same condition
Rank 1
Electroconvulsive Therapy (ECT)
90/ 100Effectiveness estimate
Safety estimate: 40 / 100
Rank 2
Venlafaxine (SNRI)
80/ 100Effectiveness estimate
Safety estimate: 60 / 100
Rank 3
Cognitive Behavioral Therapy (CBT)
78/ 100Effectiveness estimate
Safety estimate: 95 / 100
Rank 4
Sertraline (SSRI)
76/ 100Effectiveness estimate
Safety estimate: 60 / 100
Rank 5
Mirtazapine
75/ 100Effectiveness estimate
Safety estimate: 60 / 100
Top 5 of 6 treatments. Scores use a 0–100 scale, not response percentages.
Outcome Labels
Every treatment would have a label showing how much it helps and how often it harms, compared with placebo, usual care or other treatments
- How much it helps, on the scales doctors use
- How often each side effect happens, next to the comparison group
- Where every number comes from
Changes are compared with placebo in lecanemab's trials.
Bars show points of decline by the end of the trial. Shorter is better.
Share of patients who had each one.
Source: FDA label (opens in a new tab), unless noted
Every patient on Earth helps the next one
Today, results stay inside the hospital, company or country that collected them, and most treated patients add nothing to what doctors know. In one open network, a patient in Nairobi who reports how a treatment worked improves the outcome label a doctor reads in Seoul.
- Any clinic, in any country, reports outcomes in one open format.
- De-identified results are pooled in one public database. The records stay with patients and their clinics.
- Rankings and outcome labels update as results arrive, for every patient, everywhere.
Every disease gets studied in every country at once, and nobody waits for someone else's trial.
How Medicine Should Actually Work
Patients would report outcomes, doctors would see what has worked for patients like theirs, and researchers would run trials on the same network.
For patients
How Your Doctor's Visit Should Actually Work
Compare the Most Promising Treatments for Your Condition
See the treatments for your condition ranked side by side, each with an outcome label.
- Compare effectiveness, side effects and cost side by side
- See how strong the evidence is for each treatment
- Find participating clinics near you
- Talk the options over with your own doctor
View Outcome Labels
Review what is known about a treatment before deciding, with the source of every number.
- See results from trials and from treated patients
- Understand potential side effects and their frequency
- Compare with standard of care treatments
- Check the source of every value
Bars show points of decline by the end of the trial. Shorter is better.
Share of patients who had each one.
Source: FDA label (opens in a new tab)
Decide in Writing
Sign a plain-language consent with your doctor: the treatment, the risks, the unknowns and the cost.
- Sign online, after talking it over with your doctor
- Known and unknown risks in plain language
- The cost, and who pays, before you start
- Stop at any time
Coordinate Your Care
Book the trial's lab tests and visits at the clinic you already use.
- Labs and visits at your usual clinic
- Video check-ins instead of trips to a trial site
- Your records come in, so you don't repeat your history
- A reminder before each appointment
Track Outcomes
Quick check-ins record how you're doing. Every result, good or bad, improves the outcome labels for the next patient.
- A short check-in by app, text or phone
- Wearables can add sleep and activity
- Only the measures your trial needs
- Your data stays with you and your clinic
See Whether It's Working
Your check-ins are charted over time next to patients on the same treatment, so you and your doctor can decide whether to continue, change the dose or stop.
- Your scores over time, from your check-ins
- Next to patients on the same treatment
- Your doctor sees the same chart
- Problems you report are flagged for your next visit
Check In by Phone or Text
A short daily call or text asks how you feel and records your answer, so you don't fill in forms.
- Answer in your own words
- Side effects you mention go to your doctor
- A reminder when a dose is due
- Ask how your check-ins compare with others on the same treatment
Daily check-in
By phone or text
Good morning, Sarah! How are you feeling today after your treatment yesterday?
I'm feeling better today. The headache is gone but I still feel a bit tired.
Thanks, Sarah. I've recorded that, and I'll let your doctor know you still feel tired. Would you like to see how your check-ins compare with other patients on the same treatment?
Yes, please show me.
For doctors
How Treating Patients Should Work
Review Screened Options for Your Patient
See the treatments an independent board has screened for your patient's condition, ranked by the evidence so far. The ranking supports your judgment; it does not replace it.
- Options ranked by outcomes from trials and treated patients
- Eligibility checked against your patient's record
- An outcome label, with sources, for every option
- You and your patient make the decision
Recommend a Treatment, or Offer a Randomized Comparison
Recommend a screened treatment that your patient chooses with you. Or, if your patient agrees, enroll them in a centrally run randomized comparison, as the RECOVERY trial did.
- Recommend any screened treatment, with written consent
- Offer willing patients a randomized comparison
- The trial assigns treatments at random; you never pick an arm
- Compares treatments, doses or usual care, as the protocol sets
Compares screened treatments with each other or with usual care. The central trial assigns each patient at random.
Joins only with your patient's written consent.
Monitor Your Patients' Outcomes
Track how your patients are doing, report side effects in minutes, and see the same outcome categories the board publishes.
- Outcome reports straight from routine medical records
- Serious side effects reach the review board within five days
- Good, bad and unclear results are all recorded
- Compare your patients with every clinic's pooled results
P12345: Mild ARIA, reported to the board
P67890: Headache (resolved)
For researchers
How Clinical Trials Should Work
Create a Trial
Upload protocols, pre/post-clinical data, and register your supply chain in one place.
- Start from a protocol template
- Submit the protocol to an independent review board
- Keep the protocol, data and approvals in one record
Get Liability Insurance
See liability insurance priced per participant before you enroll anyone.
- Compare quotes side by side
- Priced for your trial's risks
- Cover starts before the first patient enrolls
Set Parameters
Set what your study covers for each participant and what data it collects.
- Cover participants' treatment and visit costs
- Point patients to charity and maker assistance
- Customizable data collection requirements
Manage Supply Chain & Orders
Ship treatment to participating clinics and track each order and shipment.
- Stock at each clinic, with low-stock alerts
- Patient orders filled through the clinic
- Temperature logged in transit
- An audit trail for every shipment
See Results as They Come In
Outcomes from every clinic, pooled and compared across the trial's arms while it runs.
- Results from the first patients, not only at the end
- Whether patients took their doses
- Who stopped, and who was lost to follow-up
- De-identified data to export for regulators and journals
Why Care-Integrated Clinical Trials Matter
What the network would deliver for patients, clinicians and researchers
Easier for Patients
Taking part fits into ordinary care:
- Join through your own doctor and take part from home, instead of traveling to a trial site
- See your results next to others on the same treatment
- Open to patients whom standard trials exclude
Lower Cost per Patient
Pragmatic trials show what is possible:
- The RECOVERY trial cost about $500 per patient, compared with about $41,000 in the pivotal trials behind new FDA approvals
- Data collection runs inside routine care
- Automated analysis replaces manual site work
Sources: Manhattan Institute, 2023 (RECOVERY); Moore et al., JAMA Internal Medicine, 2018.
Better Data Quality
Designed for data that researchers can check and reuse:
- Continuous data from apps and wearables, not only clinic visits
- Every number shows where it came from
- An open API for independent analysis
Faster Access to Treatments
Patients learn sooner what works:
- Outcome data from the first patients, not only at the end of a multi-year trial
- Rankings update as new evidence arrives
Partner with us
Organizations building their own
The protocol and code are open source, so you can build your own version and publish results in the same open format.
Data partners
Apps, health record systems, registries and wearable makers would share outcome data through an open API, so their users' results count toward the rankings and labels.
Advisory board
We are recruiting clinicians, researchers, ethicists, lawyers and patient advocates to advise the initiative on the protocol, patient safety and the law.