Higher Pass Rates Research Articles

Study of impacts of different evaluation criteria on gamma pass rates in VMAT QA using MatriXX and EPID

Abstract Aim: This study evaluates the impacts of using different evaluation criteria on gamma pass rates in two commercially available QA methods employed for the verification of VMAT plans using different hypothetical planning target volumes (PTVs) and anatomical regions. Introduction: Volumetric modulated arc therapy (VMAT) is a widely accepted technique to deliver highly conformal treatment in a very efficient manner. As their level of complexity is high in comparison to intensity-modulated radiotherapy (IMRT), the implementation of stringent quality assurance (QA) before treatment delivery is of paramount importance. Material and Methods: Two sets of VMAT plans were generated using Eclipse planning systems, one with five different complex hypothetical three-dimensional PTVs and one including three anatomical regions. The verification of these plans was performed using a MatriXX ionization chamber array embedded inside a MultiCube phantom and a Varian EPID dosimetric system attached to a Clinac iX. The plans were evaluated based on the 3%/3 mm, 2%/2 mm, and 1%/1 mm global gamma criteria and with three low-dose threshold values (0%, 10%, and 20%). Results: The gamma pass rates were above 95% in all VMAT plans, when the 3%/3mm gamma criterion was used and no threshold was applied. In both systems, the pass rates decreased as the criteria become stricter. Higher pass rates were observed when no threshold was applied and they tended to decrease for 10% and 20% thresholds. Conclusion: The results confirm the suitability of the equipments used and the validity of the plans. The study also confirmed that the threshold settings greatly affect the gamma pass rates, especially for lower gamma criteria.

Analysis of current situation and influencing factors on the knowledge, attitude and practice of creative credit system in a medical university

Objective To understand the situation of college students' awareness about innovative credit, analyze the influencing factors, in order to provide a scientific basis for constructing innovation credits and promoting the double strategy. Method The undergraduates of a medical university who were still at school in April 2015 were selected, and by using a stratified cluster sampling method, 450 students were chosen to be conducted by self-administered questionnaire survey to understand the cognitive status of in-novation of credit system in college students. Chi square test was used to compare the passing rates of students in different demographic characteristics, and the relationship between scores was analyzed by linear regression analysis. Result A total of 439 valid questionnaires were collected, and the total scores of innovative knowledge, attitudes and behaviors of 439 undergraduates were 15.95% (70/439), 36.44% (160/439) and 32.80% (144/439) respectively. In the part of knowledge innovation credits, girls' passing rate was higher than boys (χ2=4.010, P=0.045. In the part of attitude, high grade group students had more positive attitude than the low grade group of students (χ2=6.227, P=0.0013). In the part of behavior; higher grade students with innovative credits had higher pass rates than those in lower grades (chi, 2=7.781, P=0.005), and boys had a higher rate of passing than girls (χ2=6.658, P=0.010). The total score of knowledge was positively linear with the total score of attitude and behavior. Conclusion College Students' awareness of innovation credit rate is low, but the innovative attitude and behavior is positive. The higher the awareness rate is conducive to the cultivation of attitude and behavior, so it is necessary in medical colleges to carry out innovation of credit and promote the cultivation of innovative consciousness. Key words: Creative credit; College student; Knowledge-attitude-practice(KAP); Cross-sec-tional study

“Co-certification”: a close encounter with ELF for an international examining board

Abstract Over the last decade ELF has become a reality in European universities, but this is not reflected in the major international language tests designed for access to higher education and for university students. In this paper I describe an experiment in “co-certification,” a test of English set at level C1 of the Common European Framework of Reference (CEFR), jointly developed by Trinity College London and the University of Ca’ Foscari Venice, in which an international version of the test was adapted locally to include locally relevant components and enhance validity and task authenticity. One feature of the co-certification was the introduction of an independent listening task which took the form of understanding an extract from a lecture given in English by a non-native speaker. Possible problems we had anticipated ranged from the kind of discourse features they should include, and whether or not there was a fairness issue related to accent recognition. In fact, the overall results showed no significant difference from the previous version of the exam, while the listening part had a higher pass rate than the overall oral test which involved interaction with a native speaker. As far as we know, the co-certification is the first example of an internationally recognized board engaging systematically with characteristic features of ELF communication, notably non-native phonology and intonation patterns, in a test of listening. The findings so far suggest that, for the test takers at least, this can be unproblematic and uncontroversial.

Quality specification and status of internal quality control of cardiac biomarkers in China from 2011 to 2016.

This study aimed to investigate the status of internal quality control (IQC) for cardiac biomarkers from 2011 to 2016 so that we can have overall knowledge of the precision level of measurements in China and set appropriate precision specifications. Internal quality control data of cardiac biomarkers, including creatinine kinase MB (CK-MB) (μg/L), CK-MB(U/L), myoglobin (Mb), cardiac troponin I (cTnI), cardiac troponin T (cTnT), and homocysteines (HCY), were collected by a web-based external quality assessment (EQA) system. Percentages of laboratories meeting five precision quality specifications for current coefficient of variations (CVs) were calculated. Then, appropriate precision specifications were chosen for these six analytes. Finally, the CVs and IQC practice were further analyzed with different grouping methods. The current CVs remained nearly constant for 6years. cTnT had the highest pass rates every year against five specifications, whereas HCY had the lowest pass rates. Overall, most analytes had a satisfactory performance (pass rates >80%), except for HCY, if one-third TEa or the minimum specification were employed. When the optimal specification was applied, the performance of most analytes was frustrating (pass rates<60%) except for cTnT. The appropriate precision specifications of Mb, cTnI, cTnT and HCY were set as current CVs less than 9.20%, 9.90%, 7.50%, 10.54%, 7.63%, and 6.67%, respectively. The data of IQC practices indicated wide variation and substantial progress. The precision performance of cTnT was already satisfying, while the other five analytes, especially HCY, were still frustrating; thus, ongoing investigation and continuous improvement for IQC are still needed.

The American Board of Family Medicine: New Tools to Assist Program Directors and Graduates Achieve Success.

In this commentary we review the improvements in the pass rates for first-time American Board of Family Medicine (ABFM) Certification Examination test takers in the context of new tools and resources for program directors against the backdrop of a changing accreditation system and increased competition for a relatively fixed number of graduate medical education positions in family medicine. While causality cannot be established between the strategic initiatives of the ABFM and higher pass rates, we can all celebrate the new tools and resources provided to residents and program directors, and the improved performance of family medicine graduates on the certification examination.

A proficiency-based virtual reality endoscopy curriculum improves performance on the fundamentals of endoscopic surgery examination.

The fundamentals of endoscopic surgery (FES) examination is a national test of knowledge and skill in flexible gastrointestinal endoscopy. The skill portion of the examination involves five tasks that assesses the following skills: scope navigation, loop reduction, mucosal inspection, retroflexion, and targeting. This project aimed to assess the efficacy of a proficiency-based virtual reality (VR) curriculum in preparing residents for the FES skills exam. Experienced (>100 career colonoscopies) and inexperienced endoscopists (<50 career colonoscopies) were recruited to participate. Six VR modules were identified as reflecting the skills tested in the exam. All participants were asked to perform each of the selected modules twice, and median performance was compared between the two groups. Inexperienced endoscopists were subsequently randomized in matched pairs into a repetition (10 repetitions of each task) or proficiency curriculum. After completion of the respective curriculum, FES scores and pass rates were compared to national data and historical institutional control data (endoscopy-rotation training alone). Five experienced endoscopists and twenty-three inexperienced endoscopists participated. Construct valid metrics were identified for six modules and proficiency benchmarks were set at the median performance of experienced endoscopists. FES scores of inexperienced endoscopists in the proficiency group had significantly higher FES scores (530±86) versus historical control (386.7±92.2, p=0.0003) and higher pass rate (proficiency: 100%, historical control 61.5%, p=0.01). Trainee engagement in a VR curriculum yields superior FES performance compared to an endoscopy rotation alone. Compared to the 2012-2016 national resident pass rate of 80, 100% of trainees in a proficiency-based curriculum passed the FES manual skills examination.

Analysis of clinical competence test results of general practitioners in Shanghai Pudong New Area

Objective To analyze the clinical competency test results of general practitioners (GPs) in Shanghai Pudong New Area. Methods Total 1 160 GPs from Pudong New Area attended the clinical ability tests, all participated in theory test and 327 GPs attended practice skill tests.The results were reviewed by computer and the scores were automatically generated. Results The average score and pass rate of theory test were (64.24±12.23) points and 64.2% (745/1 155), respectively.The average scores of GPs with master or above degree were the highest (67.09±13.38 points), however, the pass rate of GPs with undergraduate degree was the highest (69.7%, 349/501). GPs with senior professional title got the highest average score and pass rate [68.26±9.92 points and 82.7% (43/52), respectively]. Introduction to General Practice (69.7%), Internal Medicine (68.6%) and Cancer (66.9%) were the top 3 subjects with the highest correct rate.The pass rate of clinical skills was 39.1% (128/327), GPs with master degree or above (192.87) and those with junior professional titles (171.08) had the highest scores.GPs with master degree or above (50.0%, 8/16) and those with intermediate professional title (40.1%, 97/242) had the highest pass rate. Conclusions The analysis shows that the average score and pass rate of both theory test and clinic practice skills test are not satisfactory among GPs in Shanghai Pudong New Area.The clinical ability of GPs need to be further improved, and the study of some specific disciplines need to be further strengthened. Key words: Clinical competence; General practitioners

Evaluation of transient-evoked otoacoustic emissions in a healthy 1 to 10 year pediatric cohort in Sub-Saharan Africa

ObjectiveTransient-evoked otoacoustic emissions (TEOAEs) monitor cochlear function. High pass rates have been reported for industrialized countries. Pass rates in low and middle income countries such as Sub-Saharan Africa are rare, essentially lower and available for children up to 4 years of age and frequently based on hospital recruitments.This study aims at providing additional TEOAE pass rates of a healthy Sub-Saharan cohort aged 1–10 years with data from Gabon, Ghana and Kenya. Potentially confounding factors (recruitment site, age) are taken into consideration. MethodsHealthy children were recruited in hospitals, schools and kindergartens. Inclusion criteria were age 1–10 years and normal otoscopic findings. Exclusion criteria were any sickness or physical ailment potentially impairing the hearing capacity. Five measurements per ear were performed with Capella Cochlear Emission Analyzer (MADSEN, Germany). An overall wave reproducibility of above 60% served as pass-criterion. Pass rates were compared between recruitment sites and age groups (1–5 and 6–10 years). ResultsOverall pass rate was 87.5% (n = 264; 231 passes vs. 33 fails). Of these 84.0% of hospital recruited children passed (n = 156; 131 passes vs. 25 fails), compared to 92.6% of community recruitments (n = 108; 100 passes vs. 8 fails), which was significantly different p = 0.039). If analyzed by age groups, this difference was only observed in children younger than 6 years (p = 0.007). ConclusionHospitals as recruitment sites for healthy controls seem to affect TEOAE pass rates. We advise for a cautious approach when recruiting healthy TEOAE control collectives under the age of 6 in a hospital setting. In children older than 6 years conventional pure-tone audiometry remains the standard method for hearing screening.

School grants and school performance in rural Cambodia

ABSTRACTWe analyse a school grant programme (Education Sector Support Scale-Up Project) implemented in roughly 600 rural primary schools in Cambodia. Detailed data from site visits are augmented with administrative data covering pre- and post-treatment years. Treatment effects are estimated using matching and fixed-effects methods. We find that school grant participation did increase budget resources, although the net impact fell short of the intended per-pupil target. Intermediate impacts in school management and community participation are mixed, but there is little evidence of increased parental engagement or satisfaction. School grants are associated with higher pass rates and student achievement levels, but these are concentrated in the earliest programme entrants, with some tapering in the post-programme period. The results highlight the challenges of instigating far-reaching changes in school management dynamics in the kinds of communities often targeted for school-based management reforms.

Impact of Online Summer Mathematics Bridge Program on Placement Scores and Pass Rates

An online four-week summer mathematics bridge program was implemented at a Midwest university with historically low pass rates in College Algebra and Remedial Mathematics. Students who completed the four week program significantly increased their mathematics placement exam scores. These students also had a higher pass rate in their initial college mathematics course compared to the overall student population taking the same courses.

Do Managers Face a Performance Trade-Off? Correlations Between Production and Process Performance

ABSTRACTThe existence of multiple goals in public organizations inevitably raises the concern that managers face performance trade-offs. In particular, scholars have expressed the fear that public managers, in order to secure high production performance, are forced to sacrifice performance on goals like equity, accountability, and procedural justice. However, our knowledge of whether such trade-offs exist is scarce. Using an administrative 10-year panel data set of Danish public schools and principals, this article analyzes trade-offs between production performance (measured by student performance and student pass rate) and process performance (measured by equity, accountability, and procedural justice). Results show no evidence of trade-offs. In contrast, principals who succeed in raising student performance generally also succeed in securing high pass rates, high equity, high accountability, and high procedural justice. These results suggest that managers who are able to secure high performance on one dimension of performance will likely also be high-performing on other performance dimensions.

Magnetic resonance only workflow and validation of dose calculations for radiotherapy of prostate cancer

Background: Current state of the art radiotherapy planning of prostate cancer utilises magnetic resonance (MR) for soft tissue delineation and computed tomography (CT) to provide an electron density map for dose calculation. This dual scan workflow is prone to setup and registration error. This study evaluates the feasibility of an MR-only workflow and the validity of dose calculation from an MR derived pseudo CT.Material and methods: Thirty prostate cancer patients were CT and MR scanned. Clinical treatment plans were generated on CT using a single 18 MV arc volumetric modulated arc therapy (VMAT) with a prescription of 78 Gy/39 fractions. Dose was recalculated on pseudo CT and assuming uniform water density. Pseudo CT and uniform density based dose calculations were compared to CT dose calculations by gamma analysis. One patient was treated with a plan based solely on MR and pseudo CT including daily image guided radiotherapy (IGRT) performed by manual match of implanted gold markers.Results: A pseudo CT was generated for 29 of the 30 patients. Median gamma pass rates for 1%/1 mm passing criteria for dose calculated on pseudo CT when compared to CT were 100% for most evaluated structures. Dose calculated on uniform density also yielded high median pass rates, but with a higher occurrence of pass rates below 95%. Cases of pass rate below 95% on pseudo CT proved to originate from the presence of rectal air on CT, not represented by the pseudo CT. Treatment based on MR alone was successfully delivered to one patient, including manually performed daily IGRT.Conclusions: Median gamma pass rates were high for pseudo CT and proved superior to uniform density. Local differences in dose calculations were concluded not to have clinical relevance. Feasibility of the MR-only workflow was demonstrated through successful delivery of a treatment course planned based on MR alone.

Design and Analysis of Multiplier Using Approximate 15-4 Compressor

This paper presents the design of approximate 15-4 compressor using 5-3 compressors as basic module. Four different types of approximate 5-3 compressors are used in a 15-4 compressor for less power consumption and high pass rate. We have analysed the results in all the cases. A $16 \times 16$ bit multiplier is simulated using the proposed 15-4 compressor. Simulation results show that the multipliers with proposed approximate compressors achieve significant improvement in power as compared to the multipliers with accurate 15-4 compressor. Pass rate of the proposed multipliers are high as compared to other existing approximate multipliers. Finally, the proposed multiplier is used in image processing applications, where the peak signal to noise ratio of the image is measured. Quality of the image is compared with an accurate multiplier and the obtained results show that our proposed multiplier performs better than existing approximate multiplier.

Student evaluation of a didactic-oriented teaching model in preclinical endodontics

Background: Current millennial-generation dental students have learning preferences which differ from students of the past. Today's dental students strongly embrace cutting edge technologies, and respond well to a pre-clinical educational curriculum which embraces Evidence-Based Dentistry. Aim: Using the elements of Chickering and Gamson's Seven Principles of Good Practice in Higher Education, this study examined the effectiveness of a contemporary teaching model which differs from the traditional passive “teaching and instruction” approach. Materials and Methods: The Institutional Review Board approved this study. Students from the combined classes of 2012 and 2013 (180 of 191) completed a 25 question survey to evaluate the effectiveness of a teaching model in Pre-clinical Endodontics. Survey questions assessed relevance of class materials, professionalism, and motivation, as well as all facets of the Teaching Model. Scoring employed a three point Likert scale: Excellent (3); Good (2); and, Poor (1). Descriptive statistics were used to determine students' perceived understanding of the course. The comparison between students' mean responses in the sophomore class of spring 2012 and the class of spring 2013 was conducted using a two sample independent t-test to test for differences in mean scores among the two groups. The survey instrument used in this class assessed encouragement of contact between students and faculty (Principle 1); development of reciprocity and cooperation among students (Principle 2); encouragement of active learning (Principle 3); prompt feedback (Principle 4); emphasis of time on task (Principle 5); communicating high expectations (Principle 6); and respecting diverse talents and ways of learning (Principle 7). Results: This paper highlights a newly designed Teaching Effectiveness Model to teach pre-clinical Endodontics to sophomore dental students. Statistical analysis of Likert scale data demonstrated a relationship between the Seven Principles and the Teaching Effectiveness Model. Conclusion: The effectiveness of this teaching model was confirmed by the high pass rate scores (98, 100%) in 2012 AND 2013 classes on the endodontic section of both the written National Board of Dental Examiners and the endodontic section of the clinical state and regional board licensing exams.

Accelerating Regulated Bioanalysis for Biotherapeutics: Case Examples Using a Microfluidic Ligand Binding Assay Platform.

The Gyrolab™ xP is a microfluidic platform for conducting ligand binding assays (LBAs) and is recognized for its utility in discovery bioanalysis. However, few reports have focused on the technology for regulated bioanalysis. This technology has the advantage of low reagent consumption, low sample volume, and automated ligand binding methods. To improve bioanalysis testing timelines and increase the speed at which biotherapeutics are delivered to patients, we evaluated the technology for its potential to deliver high-quality data at reduced testing timelines for regulated bioanalysis. Six LBA methods were validated to support bioanalysis for GLP toxicokinetic or clinical pharmacokinetic studies. Validation, sample analysis, and method transfer are described. In total, approximately 4000 samples have been tested for regulated bioanalysis to support 6 GLP toxicology studies and approximately 1000 samples to support 2 clinical studies. Gyrolab™ xP had high run pass rates (≥83%) and high incurred sample reanalysis (ISR) pass rates (>94%). The maximum total error observed across all QC levels for a given assay was <30% for all six LBAs. High instrument response precision (CV ≤5%) was observed across compact discs (CDs), and methods were validated to use a single standard curve across multiple CDs within a Gyrolab™ xP run. Reduced bioanalysis timelines were achieved compared to standard manual plate-based methods, and methods were successfully transferred across testing labs, paving the way for this platform for use in late-stage clinical development.

Frequently Assigned Readings in Behavior Analysis Graduate Training Programs.

Demand for behavior-analytic services has greatly increased in recent years, resulting in the development of many new graduate training programs. The purpose of the present study was to identify frequently assigned readings from the course syllabi of behavior-analytic training programs with the highest pass rates on the Board Certified Behavior Analyst® (BCBA®) examination. The readings are categorized by curriculum area (e.g., ethics, behaviorism, single-subject research methodology) to provide a resource for new program development and language translation efforts.

Multichannel film dosimetry vs 2D-array seven29 for vmat lung sbrt

Introduction Volumetric Modulated Arc Therapy (VMAT) can achieve high conformation and gradient levels required to deliver Stereotactic Body Radiation Therapy (SBRT). Quality Assurance (QA) usually includes a 2D gamma analysis. Here we compare two different QA procedures for VMAT lung SBRT treatments. Materials and methods Fourteen patients were selected. Dose per fraction ranged between 7.5 and 18 Gy. OCTAVIUS phantom (PTW) was used in both QA arrangements: 1. PTW 2D-ARRAY seven29 consists of a matrix of 729 cubic vented ionization chambers spaced 1 cm. To duplicate the resolution from 1 to 0,5 cm the “Merge” algorithm included in Verisoft software was used. 2. EBT3 radiochromic film with multichannel dosimetry was used. Also we applied the “efficient protocol” (Lewis, Mike and Yu, 2012) that provides specific calibration curves for each individual irradiation. Scanning was made with an Epson 10000XL, resolution was 72 dpi. Dose maps were created with Matlab. Gamma analysis criteria of 3%/3 mm and 2%/2 mm relative to maximum (MD) and local (LD) doses were performed. Results 3%/3 mm criteria: MD analysis produced averaged pass rates of 100% in both test. LD analysis gave 99.1% for EBT3 and 97.2% for 2D-array. A. 2%/2 mm criteria: MD analysis for EBT3 gave 98.9% and 90.8% for 2D-array. Also LD analysis gives 93.5% and 86.8% respectively. EBT3 provides more resolution and gives higher pass rates compared with 2D array. 3%/3 mm seems not to be an appropriate criterion. 2%/2 mm was more sensitive and gives pass rates above 96% and 91% for maximum and local dose respectively. Conclusion 2%/2 mm local dose gamma analysis of EBT3 using multichannel dosimetry gives excellent results for VMAT lung SBRT. Disclosure None.

Sci‐Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques ‐ 05: A novel respiratory motion simulation program for VMAT treatment plans: a phantom validation study

Purpose:To develop and validate a computational method to simulate craniocaudal respiratory motion in a VMAT treatment plan.Methods:Three 4DCTs of the QUASAR respiratory motion phantom were acquired with a 2cm water‐density spherical tumour embedded in cedar to simulate lung. The phantom was oscillating sinusoidally with an amplitude of 2cm and periods of 3, 4, and 5 seconds. An ITV was contoured and 5mm PTV margin was added. High and a low modulation factor VMAT plans were created for each scan. An in‐house program was developed to simulate respiratory motion in the treatment plans by shifting the MLC leaf positions relative to the phantom. Each plan was delivered to the phantom and the dose was measured using Gafchromic film. The measured and calculated plans were compared using an absolute dose gamma analysis (3%/3mm).Results:The average gamma pass rate for the low modulation plan and high modulation plans were 91.1% and 51.4% respectively. The difference between the high and low modulation plans gamma pass rates is likely related to the different sampling frequency of the respiratory curve and the higher MLC leaf speeds in the high modulation plan. A high modulation plan has a slower gantry speed and therefore samples the breathing cycle at a coarser frequency leading to inaccuracies between the measured and planned doses.Conclusion:A simple program, including a novel method for increasing sampling frequency beyond the control point frequency, has been developed to simulate respiratory motion in VMAT plans by shifting the MLC leaf positions.

Linking Research and Teaching

This paper links research and teaching through an applied Soft Systems Methodology case study. The case study focuses on the redevelopment of a Research and Professional Skills module to provide support for international postgraduate students through the use of formative feedback with the aim of increasing academic research skills and confidence. The stages of the Soft Systems Methodology were used as a structure for the redevelopment of module content and assessment. It proved to be a valuable tool for identifying complex issues, a basis for discussion and debate from which an enhanced understanding was gained and a successful solution implemented together with a case study that could be utilised for teaching Soft Systems Methodology concepts. Changes to the module were very successful and resulted in significantly higher grades and a higher pass rate.

Determination of MLC model parameters for Monaco using commercial diode arrays.

Multileaf collimators (MLCs) need to be characterized accurately in treatment planning systems to facilitate accurate intensity‐modulated radiation therapy (IMRT) and volumetric‐modulated arc therapy (VMAT). The aim of this study was to examine the use of MapCHECK 2 and ArcCHECK diode arrays for optimizing MLC parameters in Monaco X‐ray voxel Monte Carlo (XVMC) dose calculation algorithm. A series of radiation test beams designed to evaluate MLC model parameters were delivered to MapCHECK 2, ArcCHECK, and EBT3 Gafchromic film for comparison. Initial comparison of the calculated and ArcCHECK‐measured dose distributions revealed it was unclear how to change the MLC parameters to gain agreement. This ambiguity arose due to an insufficient sampling of the test field dose distributions and unexpected discrepancies in the open parts of some test fields. Consequently, the XVMC MLC parameters were optimized based on MapCHECK 2 measurements. Gafchromic EBT3 film was used to verify the accuracy of MapCHECK 2 measured dose distributions. It was found that adjustment of the MLC parameters from their default values resulted in improved global gamma analysis pass rates for MapCHECK 2 measurements versus calculated dose. The lowest pass rate of any MLC‐modulated test beam improved from 68.5% to 93.5% with 3% and 2 mm gamma criteria. Given the close agreement of the optimized model to both MapCHECK 2 and film, the optimized model was used as a benchmark to highlight the relatively large discrepancies in some of the test field dose distributions found with ArcCHECK. Comparison between the optimized model‐calculated dose and ArcCHECK‐measured dose resulted in global gamma pass rates which ranged from 70.0%–97.9% for gamma criteria of 3% and 2 mm. The simple square fields yielded high pass rates. The lower gamma pass rates were attributed to the ArcCHECK overestimating the dose in‐field for the rectangular test fields whose long axis was parallel to the long axis of the ArcCHECK. Considering ArcCHECK measurement issues and the lower gamma pass rates for the MLC‐modulated test beams, it was concluded that MapCHECK 2 was a more suitable detector than ArcCHECK for the optimization process.PACS number(s): 87.55.Qr