5: Does Peer Review of Radiation Treatment Plans Impact Clinical Care? a Systematic Review of the Literature

ABSTRACT Background: A systematic review of the literature was performed to clarify the psychosocial characteristics of patients who have an interest in cosmetic plastic surgery. Methods: Medical literature was reviewed by two independent researchers, and a third reviewer evaluated their results. Results: Twelve studies addressing the predictors of interest in cosmetic surgery were finally identified and analysed. Interest in cosmetic surgery was associated with epidemiological factors, their social networks, their psychological characteristics, such as body image, self-esteem and other personality traits and for specific psychopathology and found that these may either positively or negatively predict their motivation to seek and undergo a cosmetic procedure. Conclusions: The review examined the psychosocial characteristics associated with an interest in cosmetic surgery. Understanding cosmetic patients’ characteristics, motivation and expectation for surgery is an important aspect of their clinical care to identify those patients more likely to benefit most from the procedure.

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Impact of Peer Review in the Radiation Treatment Planning Process: Experience of a Tertiary Care University Hospital in Pakistan

Journal of Global Oncology ◽

10.1200/jgo.19.00039 ◽

2019 ◽

pp. 1-7

Author(s):

Bilal Mazhar Qureshi ◽

Muhammad Atif Mansha ◽

Muneeb Uddin Karim ◽

Asim Hafiz ◽

Nasir Ali ◽

...

Keyword(s):

Radiation Therapy ◽

Peer Review ◽

Clinical Target Volume ◽

Planning Process ◽

Radiation Treatment ◽

Tertiary Care ◽

Major Change ◽

Target Volume ◽

University Hospital ◽

Treatment Plans

PURPOSE To evaluate and report the frequency of changes in radiation therapy treatment plans after peer review in a simulation review meeting once a week. MATERIALS AND METHODS Between July 1 and August 31, 2016, the radiation plans of 116 patients were discussed in departmental simulation review meetings. All plans were finalized by the primary radiation oncologist before presenting them in the meeting. A team of radiation oncologists reviewed each plan, and their suggestions were documented as no change, major change, minor change, or missing contour. Changes were further classified as changes in clinical target volume, treatment field, or dose. All recommendations were stratified on the basis of treatment intent, site, and technique. Data were analyzed by Statistical Package for the Social Sciences and are presented descriptively. RESULTS Out of 116 plans, 26 (22.4%) were recommended for changes. Minor changes were suggested in 15 treatment plans (12.9%) and a major change in 10 (8.6%), and only one plan was suggested for missing contour. The frequency of change recommendations was greater in radical radiation plans than in palliative plans (92.3% v 7.7%). The head and neck was the most common treatment site recommended for any changes (42.3%). Most of the changes were recommended in the technique planned with three-dimensional conformal radiation therapy (50%). Clinical target volume (73.1%) was identified as the most frequent parameter suggested for any change, followed by treatment field (19.2%) and dose (0.08%). CONCLUSION Peer review is an important tool that can be used to overcome deficiencies in radiation treatment plans, with a goal of improved and individualized patient care. Our study reports changes in up to a quarter of radiotherapy plans.

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Improving the quality of care for patients receiving radiation therapy: Increasing the proportion of radiation treatment plans undergoing peer review in Ontario.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.30_suppl.136 ◽

2014 ◽

Vol 32 (30_suppl) ◽

pp. 136-136

Author(s):

Lindsay Elizabeth Reddeman ◽

Michael Donald Brundage ◽

Sophie Foxcroft ◽

Margaret Hart ◽

Eric Gutierrez ◽

...

Keyword(s):

Peer Review ◽

Success Factors ◽

Radiation Treatment ◽

Project Team ◽

Training Methods ◽

System Quality ◽

Level Data ◽

Treatment Plans ◽

One Year ◽

Professional Project

136 Background: Peer review of radiation treatment (RT) plans is recognized as an essential component of quality assurance programs in radiation medicine (Marks et al., 2013). The benefits of peer review include: (1) identifying errors that may compromise treatment outcomes, (2) enhancing safety by promoting standardization, and (3) promoting greater attention to detail in RT staff. Current state analysis conducted in 2011 identified considerable variation in the proportion of cases undergoing peer review across Ontario’s 14 cancer centres (Brundage et al., 2013). In 2012, Cancer Care Ontario launched an initiative to ensure all patients receiving radical/adjuvant radiotherapy have the benefit of peer review of their RT plans. Methods: A multi-professional project team was established to conduct site visits to promote peer review at the cancer centres. They also provided guidance on the organization of peer review rounds so that the activity could be incorporated into local workflows. The education, training, methods, and a centralized reporting infrastructure were developed in collaboration with centres over a one year ramp-up phase and patient-level data was available to the centres for audit purposes. The reporting infrastructure enabled reporting of (1) the proportion of cases peer reviewed and (2) the timing of peer review – prior to treatment, <25% dose delivered, >25% dose delivered. Results: Data for each centre is now a key quality metric and is publicly reported (see Cancer System Quality Index at http://www.csqi.on.ca/). The target for year-one of the project (2013-14) – the proportion of cases to be peer reviewed – was set at 50% with the intent that 100% of cases will be peer reviewed within the next two years. In the ramp-up year, the proportion of cases peer reviewed increased across all centres, though high variation still exists between centres. Conclusions: This initiative demonstrates that it is possible to substantially increase peer review activities on a jurisdictional basis. Key success factors include: a dedicated project team, buy-in and confidence in data quality from centres, investment in education and training, and commitment to public reporting.

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