Damaros

Agentic infrastructure for clinical trial execution.

The Trial Rift

Care happens everywhere. The trials that save lives do not.

~80%of people with cancer are treated in community clinics, not academic centersCommunity Oncology Alliance
4%enroll in a trial at community programs, versus ~22% at NCI comprehensive centersJNCI Cancer Spectrum
20+disconnected systems the average site runs daily, with no execution layer above themSCRS · WCG
01The geographic lottery

NCI-designated centers cluster in a few metros while most patients are treated hours away. Trial access follows the map, not the diagnosis, and that gate is unfair by design. Distance is the real exclusion criterion.

02The enrollment cliff

The patient who fits sits in a chart no trial will ever read. Eligibility is checked by hand, against memory, if it is checked at all, so the match dies quietly and the trial closes before anyone finds them.

03Coordinator burnout

The rare site that tries is drowning in disconnected systems that never talk, with protocol, eligibility, and audit stitched by hand, until the coordinators executing the trial burn out and the site stops saying yes.

Execution Spine

An engine decides. A human signs. Every run rebuilds itself.

Protocol

Intent becomes logic.

The protocol becomes executable law. Criteria, windows, and evidence rules compile once into versioned, locked logic, then deploy byte-identical to every site.

Evidence

Records become evidence.

Site-approved patient data arrives screening-ready, with source lineage, freshness, and mapping. The messy chart becomes admissible input; PHI never meets a model.

Screening

A verdict, not a guess.

A deterministic engine, not a model's opinion. Every criterion runs against locked logic for a PASS, REVIEW, or FAIL with evidence pointers. Anything unclear routes to a human.

Resolve

Judgment, then signature.

Node's accountability layer, standing beside the pipeline. Agents triage, rank, and stage every decision; an accountable human commits, immutable and bound to Replay. Prepared by machines, owned by a person.

Replay

Execution becomes proof.

Reconstruct any run end-to-end: Protocol, Evidence, Screening, Resolve, and who authorized it. Hash-verified, signed, and PHI-free. Not a log you trust, a proof you can replay.

No LLM verdicts PHI-bounded Replayable proof

Operations Mesh

The machinery behind governed trial execution.

Trident

Makes protocols executable.

Trial rules become usable logic.

Trident turns criteria, timelines, evidence needs, and ambiguity into clear instructions every site can run the same way.

Luna

Makes AI inspectable.

Every AI step is governed and recorded.

Luna tracks each suggestion, task, handoff, and output against policy, PHI limits, source evidence, human review, and Replay.

Eye

The execution graph, alive.

Turn the trial field into an operating system.

Eye makes protocol execution visible as it moves: where sites are ready, where evidence is missing, and where the protocol is creating friction.

Sentinel

Finds hidden protocol opportunity.

A cross-trial opportunity scan, not patient matching.

Compares PHI-free site evidence facts against enrolling criteria to surface where protocols and site reality overlap. Guarded, replayable, and never a per-patient verdict.

Trial Intelligence

Research embeds where care lives.

THE SITE

Node

Care sites become trial-capable infrastructure.

Site-governed execution.

Node admits site-approved evidence, routes review, and preserves clinician control. The site becomes sponsor-legible without becoming sponsor-controlled.

Research capacity without academic bureaucracy.

Hospitals and clinics can execute protocols with evidence, governance, and Replay while operations and patient care stay local.

THE SPONSOR

Console

Reach without operational blindness.

Command, not another dashboard.

Sponsors see permissioned execution signals from the field: evidence gaps, review burden, criterion friction, amendment pressure, and Replay completeness.

Oversight without exposure.

Track site readiness, resolution, failure, and execution drift across the network without raw patient data crossing the boundary.

Cloud, dedicated, institution-hosted, or air-gapped for federal and zero-trust environments.

Trial delays are treatment delays.

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