Analysis of a real time group consensus peer review process in radiation oncology: an evaluation of effectiveness and feasibility

Albert, Ashley; Duggar, William N; Bhandari, Rahul; Thomas, Toms Vengaloor; Packianathan, Satyaseelan; Allbright, Robert; Kanakamedala, M.R.; Mehta, Divyang; Yang, Cui; Vijayakumar, Srinivasan

doi:10.1186/s13014-018-1190-z

Cited by 14 publications

(28 citation statements)

References 18 publications

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“…Similarly to our proportion of cases peer reviewed, Albert et al [6] found 15 H&N cases (20.5%) from an overall of 73 cases presented resulting in one of the most frequently reviewed sites and also with one of the longest mean time of presentation (9 min).…”

Section: Discussionsupporting

confidence: 70%

“…Contouring corrections (53.8%) followed by dose/fractionation (26.9%) resulted in most frequent reason of change, similarly to data reported in other reviews [6,[12][13][14]16]. It is true that contouring plays an important role in our revision because it is known to be a major responsible for treatment outcomes and also isodose or DVH data are completely dependent on contour definition, especially when using IMRT-VMAT.…”

Section: Discussionsupporting

confidence: 69%

“…Previous studies identified similar proportions of recommended plan changes after peer review, accounting for 23.3 [6] [14] and 27% [11] respectively. In addition, some reviews also included changes in total dose (16.4%) or fractionation (6.8%) [6] that did not resulted in re-planning and a total minor change rate of 37 [11], 12.9 [12],7.3 [14] and 47.8% [15] respectively, which is in alignment with the 11.5% rate of minor changes obtained at our institution. Accordingly to a survey of North American teaching centers, 75% of respondents estimated that major changes occurred in < 10% whilst minor changes were estimated to be requested in < 10% of cases by 61% of respondents [5].…”

Section: Discussionmentioning

confidence: 73%

“…Other institutions have a dual-layer process with both early and late peer review evaluating different aspects. In addition, centers perform either prospective peer review (before radiation) or once the therapy has started (inside the first week) and mostly discuss only cases considered complex [2,3,6,11]. According to RD 1566/1988 [17], items such as treatment indication, contouring, isodoses, DVH and not expected reactions should be discussed in departmental clinical sessions.…”

Section: Discussionmentioning

confidence: 99%

“…Several reports have proven the benefit of peer-review process into facilitating treatment plans but also have enumerated a list of barriers to its effective implementation and efficiency such as scheduling, workload, time dedicated to peer review, equipment, repetition, the attendance by key personnel and distraction from clinic time with patients [1,[4][5][6]. In addition, there is still little guidance and limited published research about the frequency, mechanics or metrics of peer review in radiation oncology from professional organizations [1,2] so nowadays, each radiation oncology department should identify and mitigate those barriers to an effective application of peer review to its individual process and workflow.…”

Section: Introductionmentioning

confidence: 99%

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100% peer review in radiation oncology: is it feasible?

et al. 2020

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Purpose Peer review has been proposed as a strategy to ensure patient safety and plan quality in radiation oncology. Despite its potential benefits, barriers commonly exist to its optimal implementation in daily clinical routine. Our purpose is to analyze peer-review process at our institution. Methods and materials Based on our group peer-review process, we quantified the rate of plan changes, time and resources needed for this process. Prospectively, data on cases presented at our institutional peer-review conference attended by physicians, resident physicians and physicists were collected. Items such as time to present per case, type of patient (adult or pediatric), treatment intent, dose, aimed technique, disease location and receipt of previous radiation were gathered. Cases were then analyzed to determine the rate of major change, minor change and plan rejection after presentation as well as the median time per session. Results Over a period of 4 weeks, 148 cases were reviewed. Median of attendants was six physicians, three in-trainingphysicians and one physicist. Median time per session was 38 (4-72) minutes. 59.5% of cases presented in 1-4 min, 32.4% in 5-9 min and 8.1% in ≥ 10 min. 79.1% of cases were accepted without changes, 11.5% with minor changes, 6% with major changes and 3.4% were rejected with indication of new presentation. Most frequent reason of change was contouring corrections (53.8%) followed by dose or fractionation (26.9%). Conclusion Everyday group consensus peer review is an efficient manner to recollect clinical and technical data of cases presented to ensure quality radiation care before initiation of treatment as well as ensuring department quality in a feedback team environment. This model is feasible within the normal operation of every radiation oncology Department.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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100% peer review in radiation oncology: is it feasible?

et al. 2020

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Three discipline collaborative radiation therapy (3DCRT) special debate: Peer review in radiation oncology is more effective today than 20 years ago

Ahmad

Santanam

Padilla

et al. 2020

J Applied Clin Med Phys

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Radiation Oncology is a highly multidisciplinary medical specialty, drawing significantly from three scientific disciplinesmedicine, physics, and biology. As a result, discussion of controversies or changes in practice within radiation oncology must involve input from all three disciplines. For this reason, significant effort has been expended recently to foster collaborative multidisciplinary research in radiation oncology, with substantial demonstrated benefit. 1-3 In light of these results, we endeavor here to adopt this "team-science" approach to the traditional debates featured in this journal. This article is part of a series of special debates entitled "Three Discipline Collaborative Radiation Therapy (3DCRT)" in which each debate team includes a radiation oncologist, medical physicist, and radiobiologist. We hope that this format will not only be engaging for the readership but will also foster further collaboration in the science and clinical practice of radiation oncology. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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