
Biography
Dr Elizabeth Forde is a CORU registered Radiation Therapist with over 20 years of international experience working in clinical and academic environments as a radiation therapist, educator, and researcher. In her current role as Assistant Professor at Trinity College Dublin she co-ordinates several modules on the undergraduate and post-graduate programmes; challenging students to become independent, critical thinkers aligned with the Trinity Graduate Attributes. She is also Course Director of the postgraduate course in Advanced Radiation Therapy Practice (Treatment Planning strand) at Trinity College Dublin.
With clinical and academic experience across multiple international institutions, her research is dedicated to advancing radiation therapy in projects related to treatment planning, adaptive radiotherapy, and quantitative imaging analysis (radiomics) with the ultimate goal to improve the prediction, incidence, and management of radiation induced normal tissue damage. She has been successful as a primary investigator in securing competitive funding to visit clinical departments in the US, Switzerland, Italy, Ireland and, France to share knowledge and experience, and to establish research collaborations. Through these collaborations and funded projects, her doctoral research explored the value of incorporating radiomics into predictive models for xerostomia and sticky saliva in patients treated with chemoradiation for head and neck cancer. This work represented a step towards more personalised radiotherapy by integrating imaging biomarkers into treatment planning, potentially reducing long-term side effects and improving patients' quality of life.
Dr Forde recently finished serving her second term on the European Society of Radiotherapy and Oncology Board of Directors, contributing to both the strategic direction and growth of the Society. She was selected to attend the ESTRO Agora Future Leaders retreat as a participant in 2016 and invited again in the 2025 edition as a current leader. Elizabeth also supports the international scientific community via the ESTRO School. She was a long-standing faculty member and Course Director for the Advanced Skills in Modern Radiotherapy course, and has recently joined the faculty for the Artificial Intelligence in Radiotherapy Clinical Practice course.
Publications and Further Research Outputs
- Forde E, Booth J, Eade T, Kneebone A, LeMotte M and Leech M, FSD measurements are obsolete when treating prostate IMRT and VMAT, Radiotherapy and Oncology, 3rd ESTRO Forum, Barcelona, Spain, 24-28 April 2015, 115, (S (1)), Elsevier, 2015, ppS81-Oral Presentation, 2015, DOI
- Conor Nolan and Elizabeth Forde, A Review of the Use of Lipiodol and Gold Fiducials for Image Guided Bladder Radiotherapy , Acta Oncologica, 55, (5), 2016, p533 - 538Journal Article, 2016, DOI
- Conor Nolan and Elizabeth Forde, A Review of the Use of Lipiodol and Gold Fiducials for Image Guided Bladder Radiotherapy, IIRRT Anual Conference, Dublin, October 2015, 2015Poster, 2015
- Adam Moore and Elizabeth Forde, Honey I Shrunk The Bladder: A Dosimetric Evaluation of Threshold Bladder Volume for Prostate Cancer Radiotherapy, RCSI Anual Meeting, Dublin, September 2015, 2015Poster, 2015
- Mulryan, K., Leech, M., Forde, E., Effect of stereotactic dosimetric end points on overall survival for Stage I non-small cell lung cancer: A critical review, Medical Dosimetry, 2014Journal Article, 2014, DOI
- Duffy O, Forde E and Leech M, The dilemma of parotid gland and pharyngeal constrictor muscles prevention - Is daily online image guidance required? A dosimetric analysis, Medical Dosimetry, 42, 2017, p24 - 30Journal Article, 2017, DOI
- Moore A and Forde E, A Dosimetric Evaluation of Threshold Bladder Volumes for Prostate Cancer Radiotherapy, Jounral of Medical Imaging and Radiation Sciences, 2017Journal Article, 2017, DOI
- Mohan A, Forde E, Adherence to ICRU-83 reporting recommendations is inadequate in prostate dosimetry studies. , Practical Radiation Oncology, 2017Journal Article, 2017, DOI
- Glynn A, Marignol L, Forde E, Focal therapy: A treatment option for localized prostate cancer? , Advances in Modern Oncology Research, 2018Review Article, 2018, DOI
- Stritch MA, Forde E, Leech M., The impact of intensity-modulated radiation therapy plan normalization in the postprostatectomy setting-does it matter?, Medical dosimetry : official journal of the American Association of Medical Dosimetrists, 42, (4), 2017, p368-374Journal Article, 2017, DOI
- Lisa Fitzpatrick; Gerard Menezes; Elizabeth Forde and Laura Mullaney, Impact of environmental factors on IGRT image interpretation: RTTs' opinions and perceptions, ESTRO 37, Barcelona, Spain, 20-24th April 2018, 2018Oral Presentation, 2018, DOI
- Elizabeth Forde, Michelle Leech, Charlotte Robert, Elizabeth Heron, Laure Marignol, Influence of Inter-Observer Delineation Variability on Radiomic Features of the Parotid Gland, Radiotherapy and Oncology, ESTRO2020, Online, August 2020, 2020Poster, 2020, DOI
- Forde E, Leech M, Robert C, Heron E, Marignol L, Influence of Inter-Observer Delineation Variability on Radiomic Features of the Parotid Gland, Physica Medica, (82), 2021, p240 - 248Journal Article, 2021, DOI
- Rachel Barry, Elizabeth Forde, Sarah Barrett, Improving Organ at Risk Sparing in Oropharyngeal Treatment Planning by Increasing target dose: A feasibility study, Medical Dosimetry, 46, (3), 2021, p304 - 309Journal Article, 2021, DOI
- Early and Late Toxicity in Skin Radiotherapy in, editor(s)REMBIELAK, Agata Tagliaferri, Luca , Non-Melanoma Skin Cance, 2023, CRC Press, 2023, [Forde, Elizabeth; Vassiliou, Maria]Book Chapter, 2023
- Forde E, Robert C, Leech M, Marignol L., Spatial Resampling Combined with Intensity Discretization Improves Reproducibility of Radiomic Features of the Parotid Gland. (e-poster #604, European Congress of Medical Physics, Dublin, Ireland, August 2022, 2022Poster, 2022, DOI
- Forde E., Josipovic M., Kamphuis M., Lopez J., Remeijer P., Rivera S., Scherer P., Wiersema L., de Jong R., What does "Advanced" mean in 2023? reflecting on 10 years of the ESTRO advanced Skills in modern radiotherapy course, Technical Innovations and Patient Support in Radiation Oncology, 29, 2024Journal Article, 2024, DOI
- Hodgins T., Forde E., A systematic review of prostate bed motion and anisotropic margins in post-prostatectomy external beam radiotherapy, Technical Innovations and Patient Support in Radiation Oncology, 32, 2024Review, 2024, DOI
- Kirby A.M., Guckenberger M., Slotman B.J., Clark C.H., Eriksen J.G., van der Heide U., De Ioanna S., Gasparotto C., Cortese A.J., Aznar M., Borgmann K., Forde E., Jornet N., Meattini I., Tanderup K., Troost E., Verellen D., European Society of Radiotherapy and Oncology (ESTRO) strategy 2024"2026: Growth and diversification in a rapidly changing world, Radiotherapy and Oncology, 196, 2024Journal Article, 2024, DOI
- Forde E., Van den Berghe L., Buijs M., Cardone A., Daly J., Franco P., Julka-Anderson N., Lechner W., Marignol L., Marvaso G., Nisbet H., O'Donovan A., Russell N.S., Scherer P., Practical recommendations for the management of radiodermatitis: on behalf of the ESTRO RTT committee, Radiation Oncology, 20, (1), 2025Journal Article, 2025, DOI
- Atalar B, Mastroleo F, Zaffaroni M, Cremades V, Doolan P, Rønde HS, Clark CH, van der Heide UA, Boldrini L, Eriksen JG, Forde E, Kirby AM, Guckenberger M, Garibaldi C, Jereczek-Fossa BA., Understanding national Societies' needs and enhancing collaboration with ESTRO: A report of the national Societies survey 2024, on behalf of the ESTRO national Societies committee., Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 210, 2025, p111006Journal Article, 2025, DOI
- Meattini I, Aznar MC, Boldrini L, Borgmann K, Clark CH, Faivre-Finn C, Forde E, van der Heide UA, Jereczek-Fossa BA, Jornet N, Kirby AM, Ost P, Ratosa I, Tanderup K, Troost EGC, Cortese AJ, Guckenberger M., Repositioning Radiation Oncology at the centre of integrated oncology care: A manifesto of the European Society for Radiotherapy and Oncology (ESTRO)., Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 210, 2025, p111035Journal Article, 2025, DOI
- Aoibhinn Collery, Elizabeth Forde, Daily Rectal Dose-volume Histogram Variation in Prostate Intensity-modulated Radiation Therapy: Is It Clinically Significant in the Era of Image Guidance?, Journal of medical imaging and radiation sciences, 48, (4), 2017, p346 - 351, p346-351Journal Article, 2017, DOI
- Kari Tanderup, Anna M. Kirby, Jesper Grau Eriksen, Nuria Jornet, Jenny Bertholet, Chiara Gasparotto, Marianne Aznar, Luca Boldrin, Kerstin Borgmann, Catharine H. Clark, Elizabeth Forde, Barbara A. Jereczek-Fossa, Uulke A. van der Heide, Coen Hurkmans, Icro Meattini, P.I.E.T. Ost, Esther G.C. Troost, Alessandro J. Cortese, Matthias Guckenberger, ESTRO"s principles for environmental sustainability in the radiation oncology community, Radiotherapy and Oncology, 217, 2026, p111384 - 111384, p111384-111384Journal Article, 2026, DOI
- Perryck S, Anderson N, Scherer P, Forde E, Exploring staff recruitment and retention in radiation therapy: global insights from an ESTRO RTT workshop, Technical innovations and patient support in Radiation Oncology, 38, 2026, p100412-Journal Article, 2026, DOI
- A. Duffton, W. Li, E. Forde, The Pivotal Role of the Therapeutic Radiographer/Radiation Therapist in Image-guided Radiotherapy Research and Development, Clinical Oncology, 32, (12), 2020, p852--860Journal Article, 2020
- Atalar B.; Mastroleo F.; Zaffaroni M.; Cremades V.; Doolan P.; Rønde H.S.; Clark C.H.; van der Heide U.A.; Boldrini L.; Eriksen J.G.; Forde E.; Kirby A.M.; Guckenberger M.; Garibaldi C.; Jereczek-Fossa B.A., ESTRO National Societies Committee Survey 2024: Understanding National Societies needs and enhancing collaboration with ESTRO, Radiotherapy and Oncology, ESTRO2025, Vienna, Austria, May 2025, 2025Poster, 2025, DOI
- Jasmine Chen, Elizabeth Forde, Shao Hui Huang, Michelle Leech, Ali Hosni, Rouhi Fazelzad, Amy Liu, John Kim, Dosimetric and clinical impact of bone marrow-sparing radiotherapy for anal cancer: A systematic review, Radiotherapy and Oncology, ESTRO2025, Vienna, Austria, May, 2025Poster, 2025, DOI
- Forde E.; Van den Berghe L.; Buijs M.; Cardone A.; Daly J.; Franco P.; Julka-Anderson N.; Lechner W.; Marignol L.; Marvaso G.; Nisbet H.; O"Donovan A.; Russell N.S.; Scherer P., ESTRO-ACROP consensus guideline for the management of radiodermatitis, Radiotherapy and Oncology, ESTRO2024, Glasgow, Scotland, May, 2024Oral Presentation, 2024, DOI
- Elizabeth Forde, Michelle Leech, Charlotte Robert, Vjona Çifliku, Laure Marignol, Unveiling Hidden Signals: Radiomics Enhances Prediction of Acute Xerostomia and Sticky Saliva, Radiotherapy and Oncology, ESTRO2024, Glasgow, Scotland, May, 2024Poster, 2024, DOI
- Elizabeth Forde, Michelle Leech, Anita O"Donovan, Laure Marignol, Breaking Barriers in Medical Education: An Accessibility Audit of Radiotherapy Teaching Materials, Radiotherapy and Oncology, ESTRO2024, Glasgow, Scotland, May, 2024Poster, 2024, DOI
- Elizabeth Forde, Enhancing RTT Education Through UDL: A Spotlight on Treatment Planning, Radiotherapy and Oncology, ESTRO23, Vienna, Austria, May, 2023Oral Presentation, 2023, DOI
- E. Rivin del Campo, J. Cacicedo, Fernandez de Bobadilla, C. Valentini, N. Andratschke, W. Mohamed, A. Abrunhosa-Branquinho, G. Chiloiro, S. Duke, S. Hol, I. Nobre, G. óis, G. Meijer, M. Palmu, E. Forde, The elephant in the room: teaching OAR delineation in a FALCON workshop in the autosegmentation era, ESTRO21, Madrid, Spain, May, 2021Poster, 2021, DOI
- Malone C, Callens D, Forde E, Leech M, Cardenas M, Gooding M, Rya S, Thirion P, Fitzpatrick C, O'Donovan T, Carver A, Hernandez Giron I, Browne D, Rogerson C, McClean B, Heijmen B, Hanna G, Nicholson J., AI-Ready Radiation Oncology: A Consensus-Built, Validated, International Knowledge Assessment for the Radiation Oncology Workforce., Clinical and Translational Oncology, 2026Journal Article, 2026, DOI
- Jasmine Wen-Yao Chen; Elizabeth Forde; Michelle Leech; Shao Hui Huang; Olive Wong; Rouhi Fazelzad; Ali Hosni; John Kim, Dosimetric and clinical impact of bone marrow-sparing radiotherapy for anal cancer: A systematic review, Advances in Radiation Oncology, 2026Journal Article, 2026
- Forde E, Booth J and Leech M, A volumetric approach to path-length measurements is essential when treating radiotherapy with modulated beams, Medical Dosimetry, 39, (2), 2014, p194 - 196Journal Article, 2014, DOI
- Elizabeth Forde, Jeremy Booth, Michelle Leech, A volumetric approach to path length measurements is essential when treating radiotherapy with modulated beams, Medical Dosimetry, 39, (2), 2014, p194 - 196Journal Article, 2014, DOI
- Forde E, Bromley R, Kneebone A, Eade T, A class solution for volumetric modulated arc therapy planning in post prostatectomy radiotherapy., Medical Dosimetry, 39, (3), 2014, p261 - 265Journal Article, 2014, DOI
- Forde E, Kneebone A, Bromley R et al., , Volumetric modulated arc therapy in post prostatectomy radiotherapy patients: A planning comparison study, Medical Dosimetry, 38, (3), 2013, p262 - 267Journal Article, 2013, DOI
- Eade T, Guo L, Forde E et al.,, Image-guided dose-escalated intensity-modulated radiation therapy for prostate cancer: treating to doses beyond 78 Gy, BJU International, 109, (11), 2012, p1655 - 1660Journal Article, 2012, DOI
- Mulryan K, Leech M, Forde E, A Review of Dosimetric Endpoints Reported On in Clinical Trials for Stereotactic Radiotherapy for Stage I Non-Small-Cell Lung Cancer., Annual Conference of the Irish Institute of Radiography and Radiation Therapy, Dublin, Ireland, 2014Oral Presentation, 2014
- Browne M, Leech M, Forde E , Quantification of independent prostate and seminal vesicles planning margins in intermediate-risk prostate radiotherapy. , Annual Conference of the Royal College of Surgeons Ireland, Dublin, Ireland, 2014Poster, 2014
- E Forde, A Kneebone, R Bromley, P Hunt, M Back, T Eade, Volumetric Modulated Act Therapy in Post Prostatectomy Radiotherapy Patients: A Planning Comparison Study, Annual Meeting Australian Institute of Radiography, Adelaide, Australia, 2011Oral Presentation, 2011
- A Thompson, M Rinks, E Forde, K Syzmura, VMAT for Pelvic cancers Impact on planning times, Annual Meeting Australian Institute of Radiography,, Adelaide, Australia, 2011Oral Presentation, 2011
- J Booth, T Eade, E Forde, Significant Dosimetric Impact of Variable FSDs During Prostate IMRT: The Role of CBCT, AAPM Annual Meeting, Philadelphia, USA, 2010Poster, 2010, DOI
- R Skelly, A Kneebone, E Forde, J Booth, T Eade, Importance of Rectal Volume Changes During Post Prostatectomy Radiotherapy, Combined Scientific Meeting, RANZCR/AIR/FRO/ACPSEM, Brisbane, Australia, 2009Oral Presentation, 2009, URL
- E Forde, M Johnston, R Bromley, M Back, L Oliver, T Eade, An Investigation of Volumetric Modulated Arc Therapy versus Conventional Intensity Modulated Radiotherapy in Prostate Cancer Treatment, Combined Scientific Meeting, RANZCR/AIR/FRO/ACPSEM,, Brisbane, Australia, 2009Poster, 2009
- Elizabeth Forde, MRI in Radiotherapy - An RTT Perspective, Seminar in MRI for Radiotherapy, Trondheim, Norway, Dec 5th, 2018, St Olavs HospitalInvited Talk
- Forde E and Velec M, Practicalities and Not Technical Uncertainties Limit the Clinical Implementation of Adaptive Radiotherapy, ESTRO38, Milan, Italy, April 2019, 2019Invited Talk, DOI
- Elizabeth Forde, Management of Radiation Toxicities in Head and Neck Cancer, ESTRO2020, Online (Covid), May, 2020, European Society of Radiotherapy and OncologyInvited Talk, DOI
- Elizabeth Forde, Radiomics for Head and Neck Cancer, ESTRO22, Copenhagen, Denmark, May, 2022Invited Talk, DOI
- Elizabeth Forde, ePROMS: What is Possible?, ESTRO Meets Asia, Kuala Lumpur, Malaysia, August, 2024Invited Talk, DOI
- Elizabeth Forde, Burnout Amongst Radiation Oncology Professionals, ESTRO Meets Asia, Kuala Lumpur, Malaysia, August, 2024Invited Talk, DOI
- Elizabeth Forde, Adaptive Radiotherapy for Lung Cancer, Seminar on Advanced Radiotherapy Techniques in Lung Cancer, Kuala Lumpur, Malaysia, August, 2023Invited Talk
- Elizabeth Forde, Learning from ESTRO Abstract Reviewers, ESTRO 2025 RTT Pre Meeting Course, Vienna, Austria, May, 2025Invited Talk
- Elizabeth Forde, Professional Innovation in Radiotherapy, ESTRO 2026 RTT Pre Meeting Course, Stockholm, Sweeden, May, 2026Invited Talk
- Elizabeth Forde, When is close enough good enough?, ESTRO 2026, Stockholm, Sweeden, May, 2026Invited Talk
- Elizabeth Forde, Shankar Siva, My Dream for Radiation Oncology, ESTRO 2026, Stockholm, Sweden, May, 2026Invited Talk
- Elizabeth Forde, PROMs: A panel discussion, ESTRO Meets Asia, Singapore, August, 2026Invited Talk
- Elizabeth Forde, Debate: AI will significantly transform education in radiation therapy, ESTRO Meets Asia, Singapore, August, 2026Invited Talk
- Elizabeth Forde, Who Does What? The Increasing Role of the RTT, 3rd ESTRO Forum, Barcelona, Spain, 2015Invited Talk, DOI
- E Forde, In the era of CBCT, this house believes that electronic portal imaging is obsolete: Against the motion, ESTRO 33, Vienna, Austria, 2014Invited Talk, DOI
- E Forde, Head and Neck IGRT; Verification and Correction Protocols, 14th Annual All Ireland Radiation Therapy Study Day, Dublin, Ireland, 2014Invited Talk
- E Forde, Prostate IMRT: A Radiation Therapist's Perspective, Cork University Hospital Prostate Study Conference, Cork, Ireland, 2013Invited Talk
- E Forde, IMRT vs. VMAT in prostate planning...what's the difference?, Annual Meeting of the IIRRT, Dublin, Ireland, 2012Invited Talk
Research Expertise
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TitleReflective Insights into Student ExperienceSummaryThe Trinity Inclusive Curriculum Project inspired the RISE project, which supports reflective practice among radiation therapy students through creative health. The primary goal of the RISE project is to support reflective practice among radiation therapy students, allowing them to process and articulate their experiences in a therapeutic and constructive manner. By engaging in the artistic process, students will have the opportunity to explore their thoughts, emotions, and insights gained during their clinical placements.
This project aligns with the universal design for learning (UDL) principle of providing multiple means of expression. Recognising that each student may have different ways of processing and conveying their experiences, the RISE project offers a variety of creative outlets.Funding AgencyTrinity Trust and Faculty of Health Sciences Deans Innovation in Teaching AwardDate From2025 -
TitleInclusive Education in Medical CurriculaSummaryThis project dovetailed with the Inclusive Trinity Festival. This funding covered a 2-day visit of Prof Carol Clair from the University of Lausanne to provide an opportunity for TCD staff and students to engage with, and learn from, an expert in gender equality in medical education and clinical science. Prof Clair"s research area is focused on how gender and sex can influence health outcomes.Funding AgencyTCD Visiting Professor Fund
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TitleThe dosimetric impact of an off-axis contour variation when treating prostate radiotherapy with intensity and volumetric modulated fieldsSummaryDue to the modulated nature of the fields, a volumetric approach to contour variation is essential when treating with either IMRT or VMAT. The traditional central axis measurement is no longer sufficient as an indicator for dosimetric variation on target dose and fails to inform of the need for plan adaptation. This reseach quantifies the impact a body contour variation may have on the dose to the target for prostate radiotherapy.Date From2012Date To2014
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TitleRadiomics based assessment of parotid changes during head and neck radiotherapySummaryThis specific funded project forms part of a larger piece of research relating to the Quantitative Imaging Analysis of Radiation Induced Normal Tissue DamageFunding AgencyESTRO (Mobility Grant)Date From5th Nov 2018Date To10th Nov 2018
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TitleConversion of medical images into data: a novel approach to side effect prediction in oropharyngeal radiotherapy patientsSummaryThis work will test the hypothesis that radiation induced xerostomia (dry mouth) can be
predicted prior to the manifestation of clinical signs, based on retrospective quantitative
analysis of CT images taken as part of routine clinical care.Funding AgencyIrish Research CouncilDate FromDec 2021Date ToDec 2022
Radiation therapy, Cancer,
Recognition
- TCD Faculty of Health Sciences Dean's Award for Innovation in Teaching 2026
- Shortlisted - Trinity Creative Challenge 2016
- Winner - Best Poster Award IIRRT Conference 2014
- Winner - Best Poster Award IIRRT Conference 2016
- Member of Cancer Trials Ireland
- Member of European Society for Radiotherapy and Oncology
- Member of the Irish Institute of Radiography and Radiation Therapy 2021
- Member of the Irish Radiation Research Society 2022
- Member of Council: Irish Institute of Radiography and Radiation Therapy 2022
- Member of Cancer Trials Ireland
- Chair of ESTRO Membership and National Societies Taskforce 2025
- Editorial Board Member: Journal of Medical Imaging and Radiation Sciences. 2017
- National RT Education Representative and member of council for Irish Institute of Radiography and Radiotherapy 2018
- Member of ESTRO 2027 Scientific Advisory Group (RTT Track - symposium development, session chair, abstract reviewer) 2026
- Member of ESTRO Agora Future Leaders Retreat working group 2024
- IIRRT Representative for MEDIRAD Stakeholder Forum 2019
- Reviewer: Radiotherapy and Oncology; International Journal of Radiation Oncology Biology Physics; Technical Innovations and Patient Support in Radiation Oncology; Clinical and Translational Radiation Oncology; Practical Radiation Oncology; Scientific Reports, Medical Dosimetry; Journal of Medical Radiation Sciences; Journal of Medical Imaging and Radiation Sciences; Physica Medica; Clinical Oncology 2012
- Nominated Membership Officer for ESTRO 2018
- Member of ESTRO IMPACT Scientific Programme Committee 2027
- Member of ESTRO Science and Events taskforce 2025
- Faculty of ESTRO Advanced Skills in Modern Radiotherapy Course 2014
- Faculty Member of ESTRO2025 RTT Pre Meeting Course 2025
- Elected member of ESTRO Board of Directors 2020
- Mentor for ESTRO Agora Alumni project 2025
- Member of Scientific Advisory Group for ESTRO Meets Asia Congress 2024 (RTT Track - symposium development, session chair, abstract reviewer) 2023
- Mentor on ESTRO Early Career Mentoring Programme 2025
- Nominated member of the ESTRO RTT Committee 2018
- Member of ESTRO Policy and Partnership Council 2020
- Course Director ESTRO Advanced Skills in Modern Radiotherapy Course (Programme development) 2019
- Faculty of ESTRO Artificial Intelligence in Clinical Practice course 2025
- Member of Scientific Advisory Group for ESTRO Meets Asia 2026 Congress (Innovations Track - symposium development, session chair, abstract reviewer) 2026
- Chair of ESTRO RTT Clinical Trail Framework Initiative Working Group 2025