Does Peer Review of Radiation Plans Affect Clinical Care? A Systematic Review of the Literature

Kelsey Brunskill, Timothy K. Nguyen, R. Gabriel Boldt, Alexander V. Louie, Andrew Warner, Lawrence B. Marks, David A. Palma

Research output: Contribution to journalArticle

  • 7 Citations

Abstract

Purpose Peer review is a recommended component of quality assurance in radiation oncology; however, it is resource-intensive and its effect on patient care is not well understood. We conducted a systematic review of the published data to assess the reported clinical impact of peer review on radiation treatment plans. Methods and Materials A systematic review of published English studies was performed in accordance with the PRISMA guidelines using the MEDLINE and EMBASE databases and abstracts published from major radiation oncology scientific meeting proceedings. For inclusion, the studies were required to report the effect of peer review on ≥1 element of treatment planning (eg, target volume or organ-at-risk delineation, dose prescription or dosimetry). Results The initial search strategy identified 882 potentially eligible studies, with 11 meeting the inclusion criteria for full-text review and final analysis. Across a total of 11,491 patient cases, peer review programs led to modifications in a weighted mean of 10.8% of radiation treatment plans. Five studies differentiated between major and minor changes and reported weighted mean rates of change of 1.8% and 7.3%, respectively. The most common changes were related to target volume delineation (45.2% of changed plans), dose prescription or written directives (24.4%), and non-target volume delineation or normal tissue sparing (7.5%). Conclusions Our findings suggest that peer review leads to changes in clinical care in approximately 1 of every 9 cases overall. This is similar to the reported rates of change in peer review studies from other oncology-related specialties, such as radiology and pathology.

LanguageEnglish (US)
Pages27-34
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume97
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Peer Review
delineation
Radiation
radiation
Radiation Oncology
inclusions
dosage
Prescriptions
radiology
pathology
assurance
organs
Organs at Risk
dosimeters
planning
congressional reports
resources
Radiology
MEDLINE
Patient Care

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Does Peer Review of Radiation Plans Affect Clinical Care? A Systematic Review of the Literature. / Brunskill, Kelsey; Nguyen, Timothy K.; Boldt, R. Gabriel; Louie, Alexander V.; Warner, Andrew; Marks, Lawrence B.; Palma, David A.

In: International Journal of Radiation Oncology Biology Physics, Vol. 97, No. 1, 01.01.2017, p. 27-34.

Research output: Contribution to journalArticle

Brunskill, Kelsey ; Nguyen, Timothy K. ; Boldt, R. Gabriel ; Louie, Alexander V. ; Warner, Andrew ; Marks, Lawrence B. ; Palma, David A. / Does Peer Review of Radiation Plans Affect Clinical Care? A Systematic Review of the Literature. In: International Journal of Radiation Oncology Biology Physics. 2017 ; Vol. 97, No. 1. pp. 27-34.
@article{831a3bde817a4007a79f0eed80e135e5,
title = "Does Peer Review of Radiation Plans Affect Clinical Care? A Systematic Review of the Literature",
abstract = "Purpose Peer review is a recommended component of quality assurance in radiation oncology; however, it is resource-intensive and its effect on patient care is not well understood. We conducted a systematic review of the published data to assess the reported clinical impact of peer review on radiation treatment plans. Methods and Materials A systematic review of published English studies was performed in accordance with the PRISMA guidelines using the MEDLINE and EMBASE databases and abstracts published from major radiation oncology scientific meeting proceedings. For inclusion, the studies were required to report the effect of peer review on ≥1 element of treatment planning (eg, target volume or organ-at-risk delineation, dose prescription or dosimetry). Results The initial search strategy identified 882 potentially eligible studies, with 11 meeting the inclusion criteria for full-text review and final analysis. Across a total of 11,491 patient cases, peer review programs led to modifications in a weighted mean of 10.8{\%} of radiation treatment plans. Five studies differentiated between major and minor changes and reported weighted mean rates of change of 1.8{\%} and 7.3{\%}, respectively. The most common changes were related to target volume delineation (45.2{\%} of changed plans), dose prescription or written directives (24.4{\%}), and non-target volume delineation or normal tissue sparing (7.5{\%}). Conclusions Our findings suggest that peer review leads to changes in clinical care in approximately 1 of every 9 cases overall. This is similar to the reported rates of change in peer review studies from other oncology-related specialties, such as radiology and pathology.",
author = "Kelsey Brunskill and Nguyen, {Timothy K.} and Boldt, {R. Gabriel} and Louie, {Alexander V.} and Andrew Warner and Marks, {Lawrence B.} and Palma, {David A.}",
year = "2017",
month = "1",
day = "1",
doi = "10.1016/j.ijrobp.2016.09.015",
language = "English (US)",
volume = "97",
pages = "27--34",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Does Peer Review of Radiation Plans Affect Clinical Care? A Systematic Review of the Literature

AU - Brunskill, Kelsey

AU - Nguyen, Timothy K.

AU - Boldt, R. Gabriel

AU - Louie, Alexander V.

AU - Warner, Andrew

AU - Marks, Lawrence B.

AU - Palma, David A.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Purpose Peer review is a recommended component of quality assurance in radiation oncology; however, it is resource-intensive and its effect on patient care is not well understood. We conducted a systematic review of the published data to assess the reported clinical impact of peer review on radiation treatment plans. Methods and Materials A systematic review of published English studies was performed in accordance with the PRISMA guidelines using the MEDLINE and EMBASE databases and abstracts published from major radiation oncology scientific meeting proceedings. For inclusion, the studies were required to report the effect of peer review on ≥1 element of treatment planning (eg, target volume or organ-at-risk delineation, dose prescription or dosimetry). Results The initial search strategy identified 882 potentially eligible studies, with 11 meeting the inclusion criteria for full-text review and final analysis. Across a total of 11,491 patient cases, peer review programs led to modifications in a weighted mean of 10.8% of radiation treatment plans. Five studies differentiated between major and minor changes and reported weighted mean rates of change of 1.8% and 7.3%, respectively. The most common changes were related to target volume delineation (45.2% of changed plans), dose prescription or written directives (24.4%), and non-target volume delineation or normal tissue sparing (7.5%). Conclusions Our findings suggest that peer review leads to changes in clinical care in approximately 1 of every 9 cases overall. This is similar to the reported rates of change in peer review studies from other oncology-related specialties, such as radiology and pathology.

AB - Purpose Peer review is a recommended component of quality assurance in radiation oncology; however, it is resource-intensive and its effect on patient care is not well understood. We conducted a systematic review of the published data to assess the reported clinical impact of peer review on radiation treatment plans. Methods and Materials A systematic review of published English studies was performed in accordance with the PRISMA guidelines using the MEDLINE and EMBASE databases and abstracts published from major radiation oncology scientific meeting proceedings. For inclusion, the studies were required to report the effect of peer review on ≥1 element of treatment planning (eg, target volume or organ-at-risk delineation, dose prescription or dosimetry). Results The initial search strategy identified 882 potentially eligible studies, with 11 meeting the inclusion criteria for full-text review and final analysis. Across a total of 11,491 patient cases, peer review programs led to modifications in a weighted mean of 10.8% of radiation treatment plans. Five studies differentiated between major and minor changes and reported weighted mean rates of change of 1.8% and 7.3%, respectively. The most common changes were related to target volume delineation (45.2% of changed plans), dose prescription or written directives (24.4%), and non-target volume delineation or normal tissue sparing (7.5%). Conclusions Our findings suggest that peer review leads to changes in clinical care in approximately 1 of every 9 cases overall. This is similar to the reported rates of change in peer review studies from other oncology-related specialties, such as radiology and pathology.

UR - http://www.scopus.com/inward/record.url?scp=85004097370&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85004097370&partnerID=8YFLogxK

U2 - 10.1016/j.ijrobp.2016.09.015

DO - 10.1016/j.ijrobp.2016.09.015

M3 - Article

VL - 97

SP - 27

EP - 34

JO - International Journal of Radiation Oncology Biology Physics

T2 - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 1

ER -