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Author Brunskill, Kelsey ♦ Nguyen, Timothy K. ♦ Boldt, R. Gabriel ♦ Louie, Alexander V. ♦ Warner, Andrew ♦ Marks, Lawrence B. ♦ Palma, David A.
Source United States Department of Energy Office of Scientific and Technical Information
Content type Text
Language English
Subject Keyword RADIOLOGY AND NUCLEAR MEDICINE ♦ QUALITY ASSURANCE ♦ RADIATION HAZARDS ♦ RADIOTHERAPY ♦ REVIEWS
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.
ISSN 03603016
Educational Use Research
Learning Resource Type Article
Publisher Date 2017-01-01
Publisher Place United States
Journal International Journal of Radiation Oncology, Biology and Physics
Volume Number 97
Issue Number 1


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