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Peer review program to enhance treatment planning quality assurance for community radiation oncologists

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objective

Many cancer patients are treated at treatment centers staffed by community radiation oncologists (CRO). Patients choose these facilities for location convenience and anticipate equivalent care to “high volume” centers despite contrary literature. Local CROs hypothesized that a two-step quality assurance (QA) program that added early contour and case review would improve confidence in radiation treatment plan quality and reduce variability across facilities.

Methods

Five physicians at five academic satellites participated in the pilot two-step QA program. This program established an efficient, secure, HIPPA compliant workflow to review case details and contours on CT simulation after uploading to a remote access server on a commercially available platform.

Results

Over 12 months, 148 patient contours were reviewed by at least one CRO with an average of 2 reviewers per case. Reviewers approved 67% without change, requested clarification or change in 28%, and would not approve 4% of cases unless revised. The most common reasons cited for change request were “review GTV—volume increase” and “review CTV—volume increase.” Eighty-eight percent of treated cases that were not approved initially subsequently completed recommended modifications. Published literature was shared for 29% cases and sub-specialist consulted for 19% of cases.

Conclusion

A two-step QA program was considered highly valuable by all participants allowing easily implanted mechanisms for standardization, higher case volume, and shared educational resources for small academic satellite CROs who are faced with the challenge of caring for a diverse community cancer population. Feasibility suggests the model could serve as a model for other CRO.

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Author information

Authors and Affiliations

  1. Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Jessica Schuster, Greg Cooley, Adam R. Burr & Paul M. Harari

  2. University of Wisconsin Cancer Center Johnson Creek, Johnson Creek, WI, USA

    Jessica Schuster

  3. Department of Radiation Oncology, Swedish American Regional Cancer Center, Rockford, IL, USA

    Benjamin Y. Durkee

  4. Department of Radiation Oncology, Mayo Clinic La Crosse, La Crosse, WI, USA

    Anna K. Olson

Authors
  1. Jessica Schuster
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  2. Greg Cooley
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  3. Benjamin Y. Durkee
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  4. Anna K. Olson
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Correspondence to Jessica Schuster.

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The authors declare that they have no conflict of interest.

Ethical approval

This compliant report was approved by the Institutional Review Board of the University of Wisconsin as an exempt quality assurance project. This article does not contain any studies with animals. A total of 168 human participants were involved in this study.

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Schuster, J., Cooley, G., Durkee, B.Y. et al. Peer review program to enhance treatment planning quality assurance for community radiation oncologists. J Radiat Oncol 9, 131–138 (2020). https://doi.org/10.1007/s13566-020-00431-1

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  • DOI: https://doi.org/10.1007/s13566-020-00431-1

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