Various embodiments provide for decentralized crowd sourced generation of recommendation data objects. An example apparatus receives, originating from an external computing device, a recommendation data object request, the recommendation data object request comprising a user identifier and one or more user attributes. The example apparatus may further retrieve, based on a predictive recommendation model, one or more therapy identifiers associated with a therapy efficacy score exceeding a therapy efficacy score threshold for attributes of a first attributes set associated with a first cluster identifier, the first attributes set comprising one or more of the one or more user attributes. The predictive recommendation model is trained based at least in part on trusted efficacy blocks of a distributed ledger, where the trusted efficacy blocks are added to the distributed ledger when a number of therapy efficacy transaction blocks associated with a given therapy identifier and having a therapy efficacy score exceeding a therapy efficacy score threshold meets or exceeds a therapy efficacy transaction block threshold. The example apparatus may further transmit, to the external computing device, a recommendation data object configured for rendering for display via a display device of the external computing device, where the recommendation data object comprises one or more of the one or more therapy identifiers.