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Discovery

Which transitions are worth watching.

Forecasting answers a question you bring us. Discovery is for when you do not yet know which question to ask: it reads emerging evidence and surfaces the authority decisions worth asking about. The 18 entries below are the current list — each one checked against its own source by hand, not generated and left unread.

Two functions, one system

Discovery finds the question. Forecasting scores it.

Finding the right question and scoring it are separate jobs. Discovery watches evidence as it accumulates — new results, replication, expert opinion shifting. When it surfaces something, it tells you how far the evidence has moved and where it appears to be heading, not a probability. Probabilities only come from a registered forecast.

01 · Upstream Discovery Rungs 1–4

Reads the early stages — new evidence, replication, expert recognition, real-world confirmation — and surfaces the changes that look headed for a guideline, regulatory, or coverage decision.

02 · Resolvable Authority-Transition Forecasting Rungs 5–7

Takes a question — from Discovery or from you — and puts a probability and deadline on it, then gets scored on the result.

What Discovery reads

Four stages of evidence, all read from the public record.

Discovery will read the same public sources a forecast later freezes — trial registries, publications, guideline drafts, advisory committee materials, conference proceedings. Everything is timestamped and traced to a source you can check. Nothing comes from private information.

R1 · Evidence emergence

New trial results, safety signals, subgroup analyses entering the public record.

R2 · Replication & strengthening

Confirmatory data, meta-analytic convergence, and effect-size stability across cohorts.

R3 · Expert recognition

KOL convergence, review-literature consensus shifts, conference narrative change.

R4 · Real-world confirmation

RWE publication, field-level interpretation shifts, observable procedural signals.

We observe promotional, efficacy, and coverage positions only — no safety surface. Adverse-event, REMS, boxed-warning, and recall-safety intelligence is outside what we track, by design.

Read the full ladder, including observable signals and validation criteria for each rung, in the Evidence-to-Action Ladder reference.

Currently on the watchlist

13 authority decisions with an open process.

Each entry names an institution, states what that institution has itself published, and names the decision its own procedure leads to. Every line is traceable to a source you can open.

There are no probabilities here, and there will not be. A probability is attached only to a registered forecast, and none of these is one — this is a reading of the public record, scored by nobody. Entries with a dated next step come first, soonest first; then entries whose window has closed and whose output could land at any time; then entries with nothing dated. That ordering is not a ranking by importance or likelihood.

  1. 01
    European Commission — HTA Coordination Group Joint clinical assessment scope
    R7

    Joint clinical assessments have applied to new cancer medicines and advanced therapy medicinal products since January 2025. A submission request template for medical devices was updated in July 2026, and a webinar for patients and clinical experts on high-risk devices and IVDs is scheduled.

    Headed for
    Assessment route feeding national coverage decisions
    Next step
    Clinical expert webinar on high-risk devices and IVDs. 18 September 2026
  2. 02
    ICER A therapy for Parkinson's disease
    R3 → R7

    The draft scoping document went through public comment and a revised scope was scheduled to follow. The assessment covers comparative clinical effectiveness and value.

    Headed for
    Public value assessment informing payer negotiation
    Next step
    Public discussion at the California Technology Assessment Forum. October 2026
    Window closed
    27 March 2026
  3. 03
    World Health Organization Model Lists of Essential Medicines
    R3 → R5

    The application period for the 2027 update is open. Applications are assessed on effectiveness and safety alongside burden of disease, resource use, and feasibility.

    Headed for
    Revised Model Lists
    Next step
    Application deadline, 18:00 UTC. 6 November 2026
  4. 04
    ICER Treatments for Friedreich's ataxia
    R3 → R7

    The draft scoping document went through public comment and a revised scope was scheduled to follow.

    Headed for
    Public value assessment informing payer negotiation
    Next step
    Public discussion at the New England Comparative Effectiveness Public Advisory Council. January 2027
    Window closed
    16 June 2026
  5. 05
    FDA Peripheral and Central Nervous System Drugs Advisory Committee
    R6

    The committee was terminated on 4 June 2026 after its charter expired without renewal, then reestablished for a two-year period. The Commissioner determined that restoring it serves the public interest.

    Headed for
    Advisory review of neurology submissions
    Next step
    Meetings under the new charter. No date posted.
    Documented
    23 July 2026
  6. 06
    KDIGO Acute kidney injury and acute kidney disease
    R3 → R5

    A public review draft was posted in March 2026 and the review window was extended, then closed. KDIGO describes it as the first major revision of this guideline since 2012, with revised definitions that add structural biomarkers to functional criteria.

    Headed for
    Published guideline update
    Next step
    Final guideline publication. No date posted.
    Window closed
    11 May 2026
  7. 07
    KDIGO Diabetes and chronic kidney disease
    R3 → R5

    A public review draft of the 2026 guideline update was posted, covering definitions and risk assessment, glycemic monitoring, and comprehensive pharmacotherapy. The review window has closed.

    Headed for
    Published guideline update
    Next step
    Final guideline publication. No date posted.
    Window closed
    13 April 2026
  8. 08
    USPSTF Cervical cancer screening
    R3 → R5

    The topic sits in the Task Force's final stage, finalizing the recommendation statement. Public comment on the draft recommendation, draft evidence review, and draft modeling report has closed.

    Headed for
    Recommendation grade
    Next step
    Final recommendation statement. No date posted.
  9. 09
    USPSTF Prostate cancer screening
    R3 → R5

    The topic is in the developing-the-draft-recommendation stage. The standing final recommendation statement dates from 2018, and the topic does not currently carry an A or B grade.

    Headed for
    Recommendation grade
    Next step
    Draft recommendation statement posted for comment. No date posted.
  10. 10
    USPSTF Chronic kidney disease screening
    R3 → R5

    The topic is in the developing-the-draft-recommendation stage and does not currently carry an A or B grade. Two nephrology guideline revisions are moving on adjacent questions.

    Headed for
    Recommendation grade
    Next step
    Draft recommendation statement posted for comment. No date posted.
  11. 11
    NICE National HealthTech Access Programme
    R7

    NICE announced a programme, run with DHSC, NHS England, the MHRA, and the Office for Life Sciences, that routes selected health technologies into its technology appraisals programme alongside medicines. Named initial areas include capsule sponge testing for oesophageal cancer and image-analysis tools in prostate and breast cancer.

    Headed for
    National reimbursement route for selected technologies
    Next step
    Further areas under consideration. No date posted.
  12. 12
    United States federal government Core childhood vaccine recommendations
    R6 → R5

    A presidential document directing realignment of core childhood vaccine recommendations with practice in peer developed countries was published in June 2026. The charter of the committee that votes the schedule was re-established the month before.

    Headed for
    Immunization schedule votes
    Next step
    Committee votes on schedule changes. No date posted.
  13. 13
    USPSTF Cognitive impairment in older adults screening
    R3 → R5

    The topic is in the developing-the-draft-recommendation stage and does not currently carry an A or B grade.

    Headed for
    Recommendation grade
    Next step
    Draft recommendation statement posted for comment. No date posted.

Upstream of the decisions above

5 evidence questions moving before anyone has scheduled a vote.

The list above is a calendar of processes already open. This one is earlier: published evidence at rungs 1–2 that bears on a decision above, before the institution has said anything about it. Each entry names which decision it feeds.

Naming a link asserts topical bearing and nothing else. It does not claim the evidence will move the decision, and it does not claim the institution has read it. Every figure carries its denominator, and every entry carries what is wrong with it — funding conflicts, unresolved standardisation, limits on generalisability. An upstream read that omits those is advertising.

  1. 01
    Cervical cancer screening Self-collected HPV specimens
    R2

    A meta-analysis pooled 11 studies of self-collected specimens for detecting high-grade lesions or worse, reporting pooled sensitivity of 81% for self-collected urine · n = 3,534 and 88.6% for self-collected vaginal specimens · n = 3,523.

    Published
    August 2026
    Against it
    Urine sensitivity trailed vaginal sensitivity. The review attributes the gap to specimen type and collection device, which means the pooled figure does not transfer across collection methods.
  2. 02
    Parkinson's disease diagnosis Alpha-synuclein seed amplification assays
    R2

    A systematic review characterised 78 studies published between 2019 and 2025. It reports consensus on equipment and reagent concentrations, but substantial heterogeneity in incubation temperature, buffer composition, and diagnostic thresholds, with no universally validated positivity criterion.

    Published
    20 May 2026
    Against it
    The review's own conclusion is that absent harmonised protocols block clinical translation. A rising study count is not a settled assay, and this entry is on the list because of the gap, not despite it.
  3. 03
    Prostate cancer screening MRI-based screening pathways
    R2

    A review of ongoing and completed randomised screening trials reports that MRI-based pathways reduce low-grade cancer detection and biopsy rates while maintaining detection of clinically significant cancer. Several named trials are running repeated screening rounds with PSA-triggered MRI.

    Published
    16 April 2026
    Against it
    The review reports one trial's targeted pathway halves low-grade detection but misses some clinically significant cancers. It names protocol variation, reader consistency, and false positives in younger men as open problems.
  4. 04
    Alzheimer's disease detection Plasma p-tau217 in unselected cohorts
    R2

    A prototype automated plasma p-tau217 immunoassay was compared against amyloid PET classification in an unselected cohort recruited across primary and secondary care · n = 588, with discrimination peaking at an area under the curve of 0.933.

    Published
    25 March 2026
    Against it
    The study reports that reduced kidney function influences measured levels. A separate review notes implementation is harder where confirmatory testing for intermediate results is unavailable, which is the primary-care case.
  5. 05
    Chronic kidney disease screening Cost-effectiveness of population screening
    R2

    A microsimulation of the Belgian population modelled screening with one urine albumin-creatinine measurement and two eGFR measurements, reporting an incremental cost-effectiveness ratio of €3,623 per quality-adjusted life year gained in those aged 45 and over, against a stated willingness-to-pay threshold of €43,839.

    Published
    14 December 2025
    Against it
    Several authors are employees of a manufacturer of therapies used in the modelled treatment pathway. This is a model, not a trial, and its result is conditional on treatment actually being started after diagnosis.

Every entry on both lists was checked against its source on 4 August 2026. Institutions move their own dates and withdraw their own documents; open the source before relying on any line here. Where the public record is too thin to read, Discovery stays quiet rather than guessing — see when a forecast is declined.

This watchlist is assembled by reading the public record. The automated feed described above is still in development. The Evidence Change Feed records guideline, regulatory, and payer evidence changes after they happen; that history is what Discovery learns from.