Quantifying risk of tech-driven disparities

Abstract

PurposeNew technologies are continuously emerging in radiation oncology. Inherent technological limitations can result in healthcare disparities in vulnerable patient populations. These limitations must be considered for existing and new technologies in the clinic to provide equitable care. Materials and MethodsWe created a health disparity risk assessment metric inspired by failure mode and effects analysis (FMEA). We provide sample patient populations and their potential associated disparities, guidelines for clinics and vendors, and example applications of the methodology. ResultsA disparity risk priority number (dRPN) can be calculated from the product of three quantifiable metrics: the percent of patients impacted (P), the severity of the impact of dosimetric uncertainty or quality of the radiation plan (S), and the clinical dependence on the evaluated technology (C). The dRPN can be used to rank the risk of sub-optimal care due to technical limitations when comparing technologies and to plan interventions when technology is shown to have inequitable performance in the patient population of a clinic. ConclusionThe proposed methodology may simplify the evaluation of how new technology impacts vulnerable populations, help clinics quantify the limitations of their technological resources, and plan appropriate interventions to improve equity in radiation treatments.