Abstract
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.
Highlights
The multistep planning process in radiation oncology is a unique practice that often entails subjective decision making and variations among individual radiation oncologists may exist in each step
In addition to the meticulous quality assurance process that has been established by medical physicists, peer review has been proposed as a strategy to ensure plan quality and patient safety within radiation oncology
We have found that a similar method of group consensus peer review with radiation oncology offers some of these same advantages for radiation therapy plan review including real time feedback that can be incorporated into the planning process
Summary
The multistep planning process in radiation oncology is a unique practice that often entails subjective decision making and variations among individual radiation oncologists may exist in each step. Strategies to decrease error in the radiation oncology planning process are of great importance for plan quality and patient safety. In addition to the meticulous quality assurance process that has been established by medical physicists, peer review has been proposed as a strategy to ensure plan quality and patient safety within radiation oncology. Individual radiation oncology departments have established patient management plans that incorporate published literature, national guidelines, and institutional experience to ensure quality radiation care [5]. Peer review systems within radiation oncology are important to ensure quality radiation care. 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
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