Implementation and Efficacy of a Large-Scale Radiation Oncology Case-Based Peer-Review Quality Program across a Multinational Cancer Network.

Autor:	Ludmir EB; Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Hoffman KE; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Jhingran A; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Kouzy R; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Ip MP; Quality Management Programs and Cancer Network, The University of Texas MD Anderson Cancer Center, Houston, Texas., Sturdevant L; Quality Management Programs and Cancer Network, The University of Texas MD Anderson Cancer Center, Houston, Texas., Ning MS; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Minsky BD; Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., McAleer MF; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Chronowski GM; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Arzu IY; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Reed VK; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Garg AK; Department of Radiation Oncology, Presbyterian MD Anderson Radiation Treatment Center, Rio Rancho, New Mexico., Roberts T; Department of Radiation Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona., Eastwick GA; Department of Radiation Oncology, MD Anderson Cancer Center at Cooper, Camden, New Jersey., Olson MR; Department of Radiation Oncology, Baptist Medical Center, Jacksonville, Florida., Selek U; Department of Radiation Oncology, Radiation Treatment Center at American Hospital, Istanbul, Turkey., Gabel M; Department of Radiation Oncology, Summit Medical Group, New Brunswick, New Jersey., Koong AC; Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Kupferman ME; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas., Kuban DA; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: dakuban@mdanderson.org.
Jazyk:	angličtina
Zdroj:	Practical radiation oncology [Pract Radiat Oncol] 2024 May-Jun; Vol. 14 (3), pp. e173-e179. Date of Electronic Publication: 2024 Jan 03.
DOI:	10.1016/j.prro.2023.12.007
Abstrakt:	Purpose: With expansion of academic cancer center networks across geographically-dispersed sites, ensuring high-quality delivery of care across all network affiliates is essential. We report on the characteristics and efficacy of a radiation oncology peer-review quality assurance (QA) system implemented across a large-scale multinational cancer network. Methods and Materials: Since 2014, weekly case-based peer-review QA meetings have been standard for network radiation oncologists with radiation oncology faculty at a major academic center. This radiotherapy (RT) QA program involves pre-treatment peer-review of cases by disease site, with disease-site subspecialized main campus faculty members. This virtual QA platform involves direct review of the proposed RT plan as well as supporting data, including relevant pathology and imaging studies for each patient. Network RT plans were scored as being concordant or nonconcordant based on national guidelines, institutional recommendations, and/or expert judgment when considering individual patient-specific factors for a given case. Data from January 1, 2014, through December 31, 2019, were aggregated for analysis. Results: Between 2014 and 2019, across 8 network centers, a total of 16,601 RT plans underwent peer-review. The network-based peer-review case volume increased over the study period, from 958 cases in 2014 to 4,487 in 2019. A combined global nonconcordance rate of 4.5% was noted, with the highest nonconcordance rates among head-and-neck cases (11.0%). For centers that joined the network during the study period, we observed a significant decrease in the nonconcordance rate over time (3.1% average annual decrease in nonconcordance, P = 0.01); among centers that joined the network prior to the study period, nonconcordance rates remained stable over time. Conclusions: Through a standardized QA platform, network-based multinational peer-review of RT plans can be achieved. Improved concordance rates among newly added network affiliates over time are noted, suggesting a positive impact of network membership on the quality of delivered cancer care. Competing Interests: Disclosures The authors declare no relevant financial disclosures or conflicts of interest. Data sharing not available at this time. (Copyright © 2024 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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