Assessing Radiation Oncology Research Training Needs in India

Abstract

Innovation and research are necessary components for delivering cancer care. In India, where the annual incidence of cancer is projected to reach 1.7 million by 2020, the need for clinical research to establish the most effective, resource-guided, and evidence-based care is paramount. However, we recognize that access to clinical trials and training to conduct research is limited to only few radiation oncology centers in India. In this study, we sought to better understand the research training needs of radiation oncologists in India. A 12-item questionnaire was developed to assess research-training needs and was distributed at the research methods course jointly organized by Indian College of Radiation Oncology, the American Brachytherapy Society, and Education Committee of the American Society of Therapeutic Radiation Oncology during the Indian Cancer Congress, 2017. Proportions and descriptive statistics of the data were calculated. Logistic regression was used to determine factors associated with conducting research or writing a research protocol. Of 100 participants who received the questionnaire, 63% responded. Ninety percent of respondents (56/63) were Radiation Oncologists while the remaining specialties included surgical, medical oncology, and palliative care. Forty-two percent (26/63) of respondents had previously conducted research. Among these, 58% (15/26) were residents and 42% (11/26) were consultants. Longer length of practice (> 10 years) was significantly associated with conducting research (OR 6.99, p=0.031) and having formal research training trended towards significance (OR 3.03, p=0.058). The most common reason for not conducting research was ‘lack of training’ (41%, 14/34), followed by ‘lack of knowledge’ (32%, 11/34). The most common type of research conducted were Audits and Retrospective studies (62%, 16/26), followed by a Phase I/II/III Trial (46%, 10/26). Fifty-nine percent (35/59) of respondents had written a research protocol, of whom 77% (27/35) were able to develop that protocol into a study. Having formal research training was a significant factor associated with writing a protocol (OR 5.53, p=0.016). Limited training in research methods (54%, 13/24), lack of mentorship (42%, 10/24), and insufficient funding (25%, 6/24) were cited as reasons for not developing a protocol. Lack of time was cited as the most common factor (38%, 3/8) for protocols that did not develop into a study. Ninety-seven percent (57/59) of respondents were interested in a didactic session on research, specifically focusing on biostatistics. With research training, there is greater likelihood that concepts and written protocols will translate into successfully completed studies in radiation therapy. Results from clinical research will help improve practice and patient outcomes. Our study affirms that radiation oncology curriculum in India must place a greater focus on research training to not only enhance patient care but also inspire innovation within our field.