Evidence-based Peer Review for Radiation Therapy – Updated Review of the Literature with a Focus on Tumour Subsite and Treatment Modality

Huo, Michael; Gorayski, Peter; Poulsen, Michael; Thompson, Kara; Pinkham, Mark B

doi:10.1016/j.clon.2017.04.038

Cited by 30 publications

(27 citation statements)

References 33 publications

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“…In this single institution review of peer-reviewed cases, we found a major change rate of 8.2%, a total change rate 23.3%, and a mean presentation time of 8 min per case. We found this to be consistent with other reported rates of change and time per presentation [ 3 , 6 , 14 ].…”

Section: Discussionsupporting

confidence: 93%

“…In this series, we found a major plan change rate of 8.2% which is in alignment with the change rate reported for many other peer review processes [ 3 , 6 ]. In addition to major plan changes, we also tracked any type of minor change including change in total dose or dose per fraction that may not have necessitated re-planning but did represent a modification based in the peer review process.…”

Section: Discussionsupporting

confidence: 88%

“…Additionally, individual radiation oncology departments have also established patient management plans that incorporate published literature, national guidelines, and institutional experience to ensure quality radiation care [ 5 ]. Such peer review systems have been shown to result in rates of changes from 3 to 12% and the rate of change varies based on disease site in most cases [ 3 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Analysis of a real time group consensus peer review process in radiation oncology: an evaluation of effectiveness and feasibility

et al. 2018

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BackgroundPeer review systems within radiation oncology are important to ensure quality radiation care. Several individualized methods for radiation oncology peer review have been described. However, despite the importance of peer review in radiation oncology barriers may exist to its effective implementation in practice. The purpose of this study was to quantify the rate of plan changes based on our group peer review process as well as the quantify amount of time and resources needed for this process.MethodsData on cases presented in our institutional group consensus peer review conference were prospectively collected. Cases were then retrospectively analyzed to determine the rate of major change (plan rejection) and any change in plans after presentation as well as the median time of presentation. Univariable logistic regression was used to determine factors associated with major change and any change.ResultsThere were 73 cases reviewed over a period of 11 weeks. The rate of major change was 8.2% and the rate of any change was 23.3%. The majority of plans (53.4%) were presented in 6–10 min. Overall, the mean time of presentation was 8 min. On univariable logistic regression, volumetric modulated arc therapy plans were less likely to undergo a plan change but otherwise there were no factors significantly associated with major plan change or any type of change.ConclusionGroup consensus peer review allows for a large amount of informative clinical and technical data to be presented per case prior to the initiation of radiation treatment in a thorough yet efficient manner to ensure plan quality and patient safety.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

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Analysis of a real time group consensus peer review process in radiation oncology: an evaluation of effectiveness and feasibility

et al. 2018

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“…A confounding issue is that surgical or radiological treatment may need to begin before review is possible and a high rate of plan change following MDT review is likely. The rate of plan change for some cancers, including head and neck, gynecological, gastrointestinal, hematological and lung cases, has been identified as 25% …”

Section: Principles That Inform Mdt Meetingsmentioning

confidence: 99%

The challenge of putting principles into practice: Resource tensions and real‐world constraints in multidisciplinary oncology team meetings

Lamprell

Arnolda

Delaney

et al. 2019

Asia-Pac J Clncl Oncology

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The challenge of putting principles into practice: Resource tensions and real-world constraints in multidisciplinary oncology team meetings. AbstractMultidisciplinary oncology team meetings are crucial hubs for integrated, patient-centered diagnosis and treatment planning. Team meetings are designed to enact the best practice principles of multidisciplinary care. Yet surveys of clinicians and allied health providers who are members of multidisciplinary teams (MDTs) identify real-world constraints on putting principles into practice.We review the guidelines for multidisciplinary care set out by Cancer Australia and scope the realworld constraints in enacting each of these guidelines, focusing on the crucial MDT meeting component of multidisciplinary care. We discuss resources and strategies required for compliance. K E Y W O R D Scancer, clinical decision-making, resource allocationAs vital as meetings are to the effective functioning of the model, team members face time, resource and interpersonal constraints that threaten their capacity to attend meetings and to achieve quality decision-making within meetings. 7,8 Surveys of team members identify

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“…Credentialing and quality assurance are key components of safe SRT practice, 1,2 and the importance of diligent and timely quality assurance (QA) cannot be underestimated. Part of this, QA process involves peer review of treatment plans, with previous reports having highlighted the importance of a peer‐reviewed chart round, and its positive clinical impact 3‐7 …”

Section: Introductionmentioning

confidence: 99%

Quality and access – Early experience of implementing a virtual stereotactic chart round across a national network

et al. 2020

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Introduction Stereotactic radiation therapy is a highly specialised technique which requires careful and structured implementation. As part of a national stereotactic programme implementation, protocols were developed and a national stereotactic chart round was formed, which strongly recommended attendance and presentation of all cases before treatment. Herein, we describe our experiences launching a national chart round and its importance in a stereotactic programme. Method Stereotactic chart rounds were held via videoconference between July 2018 and July 2019. Data collected included attendances, patient‐related information including, diagnosis, clinical background, treatment intent, prescribed dose and fractionation and technical approach. Consensus recommendations regarding changes to treatment approaches were also recorded. Results For the 12 months recorded, there were 1126 attendances, from 144 individual attendees, across 21 locations. In total, 285 cases (237 new cases, and 48 re‐presentations) were presented by 27 radiation oncologists (ROs) from 13 different locations. From the cases presented, 65 changes were recommended from 53 patients (22.3%), including 27 (11.4%) changes to contours, 18 (7.6%) changes to dose prescription/fractionation, 9 (3.8%) changes to plan dosimetry, 1 (0.4%) changes to treatment technique and 10 (4.2%) recommendations for which stereotactic radiation therapy was not advised. A significant inverse relationship was found between frequency of recommended changes and the individual RO’s stereotactic case load (P < 0.002). Conclusion The implementation of a national stereotactic chart held via videoconference has ensured national protocol compliance across the network of locations. Furthermore, the chart rounds have allowed the entire multidisciplinary team to be provided with mentorship and guidance. Increasing number of cases presented was associated with lower rates of recommended changes highlighting the impact of experience and the need for continued mentorship.

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Evidence-based Peer Review for Radiation Therapy – Updated Review of the Literature with a Focus on Tumour Subsite and Treatment Modality

Cited by 30 publications

References 33 publications

Analysis of a real time group consensus peer review process in radiation oncology: an evaluation of effectiveness and feasibility

Analysis of a real time group consensus peer review process in radiation oncology: an evaluation of effectiveness and feasibility

The challenge of putting principles into practice: Resource tensions and real‐world constraints in multidisciplinary oncology team meetings

Quality and access – Early experience of implementing a virtual stereotactic chart round across a national network

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