Expert Consensus

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Neurology

By 2028, aducanumab will have been withdrawn or deprioritized in favor of later anti-amyloid agents with cleaner efficacy signals.

Neurology · Linked to published work ( 0)

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Expert Consensus

By 2028, aducanumab will have been withdrawn or deprioritized in favor of later anti-amyloid agents with cleaner efficacy signals.

By 2028, late-window thrombectomy (6–24h) will be explicitly endorsed by AHA/ASA guidelines as standard-of-care in qualifying LVO patients across at least 80% of US comprehensive stroke centers.

By 2028, exa-cel or a comparable ex vivo gene-edited therapy will have treated >500 SCD patients globally with a durable VOC-free rate >90% at 3 years.

By 2028, neoadjuvant checkpoint inhibition will be standard-of-care for stage II–III TNBC across major oncology guidelines.

By 2028, anti-amyloid antibodies will have a net positive impact on real-world CDR-SB trajectories, but uptake will remain <25% of eligible early AD patients due to ARIA monitoring burden.

By 2028, flow-diverter use will extend to posterior circulation aneurysms with safety non-inferior to anterior-circulation benchmarks.

By 2028, DBS referral in PD will routinely be considered within 5 years of motor-complication onset (vs. the historical ≥10-year pattern).

By 2028, stent retrievers will remain first-line device class, with next-gen aspiration-plus-stent hybrids not yet unseating them in RCTs.

By 2028, quadruple therapy (ACEi/ARNI + BB + MRA + SGLT2i) will be the default HFrEF regimen in US registries.

By 2028, at least two sickle cell gene-therapy products will compete head-to-head on real-world VOC-free survival and cost-effectiveness.

By 2028, antibody-drug conjugates (T-DXd class) will have largely displaced T-DM1 as second-line HER2+ metastatic therapy.

The cardiovascular benefit of PCSK9 inhibition with alirocumab will be confirmed as a class effect applicable to other PCSK9 inhibitors in post-ACS patients on maximally tolerated statin therapy.

By 2028, CT-perfusion will be standard at the majority of thrombectomy-capable centers, matching the EXTEND-IA selection criteria.

By 2028, median door-to-puncture time at thrombectomy centers will meet or beat the ESCAPE benchmark of ≤60 minutes.

PD-L1 tumor expression status will serve as a clinically validated predictive biomarker to guide selection between nivolumab monotherapy and combination nivolumab plus ipilimumab in metastatic melanoma.

By 2028, 10-year survival data from CheckMate-067 will show a plateau ≥40% in the combination arm.

By 2028, ARNI will remain preferred over ACEi as baseline RAS modulation in HFrEF across US and EU guidelines.

By 2028, long-term follow-up will show durability of Zolgensma motor benefit plateau at ≥5 years post-infusion in early-treated cohorts.

By 2028, ≥40% of cSDH evacuations at academic centers will include adjunctive MMA embolization.

By 2028, elective PCI rates for stable CAD will have declined by ≥15% in the US post-ISCHEMIA, stabilizing at a new lower baseline.

The cardiovascular benefit of evolocumab will be shown to persist or increase with longer follow-up beyond the 2.2-year median observed in the FOURIER trial.

Pembrolizumab's PFS and OS benefit over ipilimumab in advanced melanoma will be maintained at longer follow-up beyond the median 7.9-month observation period reported in this trial.

LCZ696 will demonstrate superiority over enalapril in reducing cardiovascular death or heart failure hospitalization across diverse real-world HFrEF populations, including those underrepresented in PARADIGM-HF.

By 2028, MMA embolization will be incorporated into AANS/CNS guidelines as a recommended adjunct for recurrent cSDH.

By 2028, oral CGRP antagonists will be first-line preventive therapy for episodic migraine, surpassing beta-blockers in new prescriptions.

By 2028, SGLT2 inhibitors will be prescribed for ≥70% of eligible HFrEF patients at guideline-adherent cardiology practices.

By 2028, pembrolizumab-containing regimens will be first-line for >90% of eligible metastatic non-squamous NSCLC in US practice.

By 2028, outcomes observed in the REVASCAT 8h arm will replicate in at least three independent national registries.

The benefit of late-window thrombectomy identified in DEFUSE 3 will generalize to stroke patients with posterior circulation (basilar artery) occlusion selected by perfusion imaging in the 6-16 hour window.

Eliminating CT scans from routine surveillance programs for favorable-histology Wilms tumor is unlikely to compromise patient survival while substantially reducing radiation exposure and healthcare costs.

By 2028, one-time AAV gene therapy for severe hemophilia B will show ≥5-year FIX expression durability in >70% of treated patients.

The cardiovascular benefit of icosapent ethyl will not be replicated by other omega-3 fatty acid formulations containing DHA in addition to EPA at comparable doses.

By 2028, the MR CLEAN effect size (~13% absolute mRS 0–2 improvement) will be confirmed within ±3 points in pooled real-world US registries.

By 2028, imaging-based (CTP/MR) selection for late-window thrombectomy will be reimbursed by CMS without pre-authorization.

Durvalumab consolidation after chemoradiotherapy will demonstrate a statistically significant overall survival benefit in the final analysis of the PACIFIC trial in stage III unresectable NSCLC.

By 2028, universal newborn SMA screening + early nusinersen (or onasemnogene/risdiplam) will be standard across all US states and most EU countries.

By 2028, sham-controlled trials (ORBITA-2 and successors) will define reimbursement criteria for elective PCI in stable CAD.

By 2028, CDK4/6 inhibitors will remain standard first-line for HR+/HER2− metastatic breast cancer; resistance-overcoming agents (e.g., AKT/PI3K) will be layered on top.

By 2028, at least two additional subretinal gene therapies (beyond LUXTURNA) will be FDA-approved for monogenic retinal dystrophies.