Julie Rouette1, Eric Gutierrez2, Jennifer O'Donnell1, Lindsay Reddeman2, Margaret Hart3, Sophie Foxcroft4, Gunita Mitera5, Padraig Warde6, Michael D Brundage7. 1. Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada. 2. Radiation Treatment Program, Cancer Care Ontario, Toronto, Ontario, Canada. 3. Radiation Treatment Program, Cancer Care Ontario, Toronto, Ontario, Canada; R.S. McLaughlin Durham Regional Cancer Centre, Oshawa, Ontario, Canada. 4. Radiation Treatment Program, Cancer Care Ontario, Toronto, Ontario, Canada; Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario, Canada. 5. Canadian Partnership Against Cancer, Toronto, Ontario, Canada. 6. Radiation Treatment Program, Cancer Care Ontario, Toronto, Ontario, Canada; Radiation Medicine Program, Princess Margaret Hospital, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada. 7. Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada; Department of Oncology, Queen's University, Kingston, Ontario, Canada. Electronic address: michael.brundage@krcc.on.ca.
Abstract
PURPOSE: To describe the outcomes of peer review across all 14 cancer centers in Ontario. METHODS AND MATERIALS: We identified all peer-reviewed, curative treatment plans delivered in Ontario within a 3-month study period from 2013 to 2014 using a provincial cancer treatment database and collected additional data on the peer-review outcomes. RESULTS: Considerable variation was found in the proportion of peer-reviewed plans across the centers (average 70.2%, range 40.8%-99.2%). During the study period, 5561 curative plans underwent peer review. Of those, 184 plans (3.3%) had changes recommended. Of the 184 plans, the changes were major (defined as requiring repeat planning or having a major effect on planning or clinical outcomes, or both) in 40.2% and minor in 47.8%. For the remaining 12.0%, data were missing. The proportions of recommended changes varied among disease sites (0.0%-7.0%). The disease sites with the most recommended changes to treatment plans after peer review and with the greatest potential for benefit were the esophagus (7.0%), uterus (6.7%), upper limb (6.3%), cervix and lower limb (both 6.0%), head and neck and bilateral lung (both 5.9%), right supraclavicular lymph nodes (5.7%), rectum (5.3%), and spine (5.0%). Although the heart is an organ at risk in left-sided breast treatment plans, the proportions of recommended changes did not significantly differ between the left breast treatment plans (3.0%, 95% confidence interval 2.0%-4.5%) and right breast treatment plans (2.4%, 95% confidence interval 1.5%-3.8%). The recommended changes were more frequently made when peer review occurred before radiation therapy (3.8%) than during treatment (1.4%-2.8%; P=.0048). The proportion of plans with recommended changes was not significantly associated with patient volume (P=.23), peer-review performance (P=.36), or center academic status (P=.75). CONCLUSIONS: Peer review of treatment plans directly affects the quality of care by identifying important clinical and planning changes. Provincial strategies are underway to optimize its conduct in radiation oncology.
PURPOSE: To describe the outcomes of peer review across all 14 cancer centers in Ontario. METHODS AND MATERIALS: We identified all peer-reviewed, curative treatment plans delivered in Ontario within a 3-month study period from 2013 to 2014 using a provincial cancer treatment database and collected additional data on the peer-review outcomes. RESULTS: Considerable variation was found in the proportion of peer-reviewed plans across the centers (average 70.2%, range 40.8%-99.2%). During the study period, 5561 curative plans underwent peer review. Of those, 184 plans (3.3%) had changes recommended. Of the 184 plans, the changes were major (defined as requiring repeat planning or having a major effect on planning or clinical outcomes, or both) in 40.2% and minor in 47.8%. For the remaining 12.0%, data were missing. The proportions of recommended changes varied among disease sites (0.0%-7.0%). The disease sites with the most recommended changes to treatment plans after peer review and with the greatest potential for benefit were the esophagus (7.0%), uterus (6.7%), upper limb (6.3%), cervix and lower limb (both 6.0%), head and neck and bilateral lung (both 5.9%), right supraclavicular lymph nodes (5.7%), rectum (5.3%), and spine (5.0%). Although the heart is an organ at risk in left-sided breast treatment plans, the proportions of recommended changes did not significantly differ between the left breast treatment plans (3.0%, 95% confidence interval 2.0%-4.5%) and right breast treatment plans (2.4%, 95% confidence interval 1.5%-3.8%). The recommended changes were more frequently made when peer review occurred before radiation therapy (3.8%) than during treatment (1.4%-2.8%; P=.0048). The proportion of plans with recommended changes was not significantly associated with patient volume (P=.23), peer-review performance (P=.36), or center academic status (P=.75). CONCLUSIONS: Peer review of treatment plans directly affects the quality of care by identifying important clinical and planning changes. Provincial strategies are underway to optimize its conduct in radiation oncology.
Authors: E Martin-Garcia; F Celada-Álvarez; M J Pérez-Calatayud; M Rodriguez-Pla; O Prato-Carreño; D Farga-Albiol; O Pons-Llanas; S Roldán-Ortega; E Collado-Ballesteros; F J Martinez-Arcelus; Y Bernisz-Diaz; V A Macias; J Chimeno; J Gimeno-Olmos; F Lliso; V Carmona; J C Ruiz; J Pérez-Calatayud; A Tormo-Micó; A J Conde-Moreno Journal: Clin Transl Oncol Date: 2020-06-15 Impact factor: 3.405
Authors: Anis Ahmad; Lakshmi Santanam; Abhishek A Solanki; Laura Padilla; Erina Vlashi; Patrizia Guerrieri; Michael M Dominello; Jay Burmeister; Michael C Joiner Journal: J Appl Clin Med Phys Date: 2020-11-24 Impact factor: 2.243