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

Publication date: Available online 20 September 2016
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Kelsey Brunskill, Timothy K. Nguyen, R. Gabriel Boldt, Alexander V. Louie, Andrew Warner, Lawrence B. Marks, David A. Palma
PurposePeer 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 literature to assess the reported clinical impact of peer review on radiotherapy treatment plans.MethodsA systematic review of the English literature was executed following PRISMA guidelines, including MEDLINE, EMBASE, and abstracts published from major radiation oncology scientific meeting proceedings. For inclusion, studies were required to report the impact of peer review on at least one element of treatment planning (e.g. target volume or organat- risk delineation, dose prescription, or dosimetry).ResultsThe initial search strategy identified 882 potentially eligible studies with 11 meeting 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 2.7% and 7.3% respectively. The most common changes 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%).ConclusionsOur findings suggest that peer review leads to changes in clinical care in approximately 1 out every 9 cases overall. This is similar to reported rates of change in peer review studies from other oncology-related specialties, such as radiology and pathology.



from Cancer via ola Kala on Inoreader http://ift.tt/2d6OazQ
via IFTTT