Toward automation of initial chart check for photon/electron EBRT: the clinical implementation of new AAPM task group reports and automation techniques

Xu, Huijun; Zhang, Baoshe; Guerrero, Mariana; Lee, Sung‐Woo; Lamichhane, Narottam; Chen, Shifeng; Yi, B

doi:10.1002/acm2.13200

Cited by 5 publications

(6 citation statements)

References 38 publications

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“…16 Xu et al were able to automate substantial portions of the TG 275 checklist recommendations, thereby limiting manual checking effort and reducing plan check time from 44% to 98%. 17 To increase the likelihood of error detection and reduce variability among physicists, we have designed and implemented an in-house automated plan check script in the treatment planning system which includes many checks from the sample checklist in Table S1.A.iii in TG 275 2 and Table 8 in MPPG 11.A. 3 The script is designed to check several parameters manually entered in the treatment planning system against data available in the record and verify system including total dose, fraction size, the number of fractions, inclusion of correct support structure, treatment machine, and several others.…”

Section: Discussionmentioning

confidence: 99%

“…Xu et al. were able to automate substantial portions of the TG 275 checklist recommendations, thereby limiting manual checking effort and reducing plan check time from 44% to 98% 17 . To increase the likelihood of error detection and reduce variability among physicists, we have designed and implemented an in‐house automated plan check script in the treatment planning system which includes many checks from the sample checklist in Table S1.A.iii in TG 275 2 and Table 8 in MPPG 11.A 3 .…”

Section: Discussionmentioning

confidence: 99%

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Assessing initial plan check efficacy using TG 275 failure modes and incident reporting

Riegel

Polvorosa

Sharma

et al. 2022

J Applied Clin Med Phys

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Plan checks are important components of a robust quality assurance (QA) program. Recently, the American Association of Physicists in Medicine (AAPM) published two reports concerning plan and chart checking, Task Group (TG) 275 and Medical Physics Practice Guideline (MPPG) 11.A. The purpose of the current study was to crosswalk initial plan check failure modes revealed in TG 275 against our institutional QA program and local incident reporting data. Ten physicists reviewed 46 high-risk failure modes reported in Table S1.A.i of the TG 275 report. The committee identified steps in our planning process which sufficiently checked each failure mode. Failure modes that were not covered were noted for follow-up. A multidisciplinary committee reviewed the narratives of 1599 locally-reported incidents in our Radiation Oncology Incident Learning System (ROILS) database and categorized each into the high-risk TG 275 failure modes. We found that over half of the 46 high-risk failure modes, six of which were top-ten failure modes, were covered in part by daily contouring peer-review rounds, upstream of the traditional initial plan check. Five failure modes were not adequately covered, three of which concerned pregnancy, pacemakers, and prior dose. Of the 1599 incidents analyzed, 710 were germane to the initial plan check, 23.4% of which concerned missing pregnancy attestations. Most, however, were caught prior to CT simulation (98.8%). Physics review and initial plan check were the least efficacious checks, with error detection rates of 31.8% and 31.3%, respectively, for some failure modes. Our QA process that includes daily contouring rounds resulted in increased upstream error detection. This work has led to several initiatives in the department, including increased automation and enhancement of several policies and procedures. With TG 275 and MPPG 11.A as a guide, we strongly recommend that departments consider an internal chart checking policy and procedure review.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessing initial plan check efficacy using TG 275 failure modes and incident reporting

Riegel

Polvorosa

Sharma

et al. 2022

J Applied Clin Med Phys

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“…The initial chart review is one of the most effective ways of diagnosing pretreatment errors and ensuring compliance with the prescription. 17 Since the largest number of errors occurs during the planning and the pretreatment processes, chart review represents an opportunity to improve the quality assurance of the entire workflow. 18 Similarly, the weekly chart review also plays a significant role in providing quality control during the course of patient treatment to catch or rule out any gross errors.…”

Section: Opening Statementsmentioning

confidence: 99%

“…The process of chart review occurs within various steps of a clinical physics workflow such as pretreatment initial chart review, weekly chart review, and end of treatment chart review. The initial chart review is one of the most effective ways of diagnosing pretreatment errors and ensuring compliance with the prescription 17 . Since the largest number of errors occurs during the planning and the pretreatment processes, chart review represents an opportunity to improve the quality assurance of the entire workflow 18 .…”

Section: Opening Statementsmentioning

confidence: 99%

Three discipline collaborative radiation therapy (3DCRT) special debate: A physicist's time is better spent in direct patient/provider interaction than in the patient's chart

Atwood

Lamichhane

Howell

et al. 2022

J Applied Clin Med Phys

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both engaging for the readership and foster further collaboration in the science and clinical practice of radiation oncology. All 3DCRT debates thus far have included a radiation oncologist, medical physicist, and radiobiologist on each team. For this debate, we break that trend and include a patient representative along with a radiation oncologist and medical physicist on each team. We hope this patient perspective adds a valuable new aspect to our debate format and encourages the continued inclusion of patient perspectives in future clinical discussions.

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“…Repetitive work would lead to fatigue, which may affect the attention to detail and thoroughness of the review, potentially increasing the risk of oversights. [11,12] Several researchers developed methods to complement manual review process with computer-aided solutions. [13][14][15][16][17][18] Holdsworth et al developed an in-house software called Veri er, which was designed to improve the e cacy and e ciency of radiation therapy treatment planning and quality control review.…”

Section: Introductionmentioning

confidence: 99%

Developing an Automatic Treatment Record Review System for Quality Assurance of Patient Treatment Delivery in Radiation Therapy

Huang,

Xu,

Huan

et al. 2024

Preprint

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Background and Purpose Treatment record contains most of information related to treatment plan delivery in radiation therapy. Reviewing treatment record is an important quality assurance (QA) task for safety and quality of patient treatments. This task is usually performed by senior medical physicists. However, it is time-consuming, tedious, and error-prone. To assist this process, a treatment record review system (TRRS) is developed to automatically review items related to treatment delivery record. Methods The treatment record is firstly extracted from oncology information system(OIS). Based on the daily patient treatment information, the original plan from the treatment planning system is identified. Then the original plan and the delivered plan are correlated. Eight review categories (parameter consistency, treatment completeness, treatment progression, image guidance, override, treatment couch, documentation, and treatment mode) are defined. Tailored rules are designed for various review items to automate the review process. As a result, for each treatment record on a daily basis, a review flag (pass, failure, warning, and N/A) is determined by TRRS. Finally, this system is evaluated using six months patient treatment records collected in our institute and compared to the manual process on the same database. Results TRRS automatically reviewed a total of 76651 treatment fractions from 4230 patients with an average of 574 treatments per day. The average abnormality rate was 0.76%. The average processing time per treatment record was 3.9 seconds and 282 seconds for the automatic and manual processes, respectively. Comparing with the manual process, the time efficiency of TRRS is improved by a factor of 72. The average numbers of anomalies detected by the automatic and manual processes are 21 and 13 per day, respectively. TRRS detects 61.5% more anomalies than those of the manual process. Conclusion TRRS is not only efficient in processing a large amount of treatment records on a daily basis but also effective in finding more anomalies than those of physics weekly check. The application of the automatic review system could significantly reduce the work of review physicists and let them focus on more important works related to patient safety.

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Toward automation of initial chart check for photon/electron EBRT: the clinical implementation of new AAPM task group reports and automation techniques

Cited by 5 publications

References 38 publications

Assessing initial plan check efficacy using TG 275 failure modes and incident reporting

Assessing initial plan check efficacy using TG 275 failure modes and incident reporting

Three discipline collaborative radiation therapy (3DCRT) special debate: A physicist's time is better spent in direct patient/provider interaction than in the patient's chart

Developing an Automatic Treatment Record Review System for Quality Assurance of Patient Treatment Delivery in Radiation Therapy

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