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Title: WE-A-BRC-03: Lessons Learned: IROC Audits

Abstract

Quality and safety in healthcare are inextricably linked. There are compelling data that link poor quality radiation therapy to inferior patient survival. Radiation Oncology clinical trial protocol deviations often involve incorrect target volume delineation or dosing, akin to radiotherapy incidents which also often involve partial geometric miss or improper radiation dosing. When patients with radiation protocol variations are compared to those without significant protocol variations, clinical outcome is negatively impacted. Traditionally, quality assurance in radiation oncology has been driven largely by new technological advances, and safety improvement has been driven by reactive responses to past system failures and prescriptive mandates recommended by professional organizations and promulgated by regulators. Prescriptive approaches to quality and safety alone often do not address the huge variety of process and technique used in radiation oncology. Risk-based assessments of radiotherapy processes provide a mechanism to enhance quality and safety, both for new and for established techniques. It is imperative that we explore such a paradigm shift at this time, when expectations from patients as well as providers are rising while available resources are falling. There is much we can learn from our past experiences to be applied towards the new risk-based assessments. Learning Objectives: Understand themore » impact of clinical and technical quality on outcomes Understand the importance of quality care in radiation oncology Learn to assess the impact of quality on clinical outcomes D. Followill, NIH Grant CA180803.« less

Authors:
 [1]
  1. UT MD Anderson Cancer Center (United States)
Publication Date:
OSTI Identifier:
22654088
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; CLINICAL TRIALS; LEARNING; PATIENTS; QUALITY ASSURANCE; RADIATION DOSES; RADIOTHERAPY; SAFETY

Citation Formats

Followill, D. WE-A-BRC-03: Lessons Learned: IROC Audits. United States: N. p., 2016. Web. doi:10.1118/1.4957724.
Followill, D. WE-A-BRC-03: Lessons Learned: IROC Audits. United States. doi:10.1118/1.4957724.
Followill, D. 2016. "WE-A-BRC-03: Lessons Learned: IROC Audits". United States. doi:10.1118/1.4957724.
@article{osti_22654088,
title = {WE-A-BRC-03: Lessons Learned: IROC Audits},
author = {Followill, D.},
abstractNote = {Quality and safety in healthcare are inextricably linked. There are compelling data that link poor quality radiation therapy to inferior patient survival. Radiation Oncology clinical trial protocol deviations often involve incorrect target volume delineation or dosing, akin to radiotherapy incidents which also often involve partial geometric miss or improper radiation dosing. When patients with radiation protocol variations are compared to those without significant protocol variations, clinical outcome is negatively impacted. Traditionally, quality assurance in radiation oncology has been driven largely by new technological advances, and safety improvement has been driven by reactive responses to past system failures and prescriptive mandates recommended by professional organizations and promulgated by regulators. Prescriptive approaches to quality and safety alone often do not address the huge variety of process and technique used in radiation oncology. Risk-based assessments of radiotherapy processes provide a mechanism to enhance quality and safety, both for new and for established techniques. It is imperative that we explore such a paradigm shift at this time, when expectations from patients as well as providers are rising while available resources are falling. There is much we can learn from our past experiences to be applied towards the new risk-based assessments. Learning Objectives: Understand the impact of clinical and technical quality on outcomes Understand the importance of quality care in radiation oncology Learn to assess the impact of quality on clinical outcomes D. Followill, NIH Grant CA180803.},
doi = {10.1118/1.4957724},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: Analysis of the performance of the microSTARii reader for optically stimulated luminescence dosimeters (OSLD) used by the IROC Houston Quality Assurance Center (IROC HQAC) for external audits compare to the characteristics of the Microstar reader. Methods: The IROC HQAC uses the Microstar reader for the OSLD program for verification of output of photon, electron and proton beams. The calculation of dose from the OSLD system is based on a group of factors defined at time of the commissioning of a batch of detectors. Factors like system sensitivity (SS), depletion (KD), element correction factor (ECF), linearity (KL), energy correction (KE).more » The new microSTARii unit presents many hardware and software upgrades that were considered useful for this program. Based on these changes many factors, that were considered reader dependent, were revised in order to analyze the effect of the new reading process. The SS, KD, ECF and KL were evaluated and compared with data defined based on reading done on Microstar reader. Results: The SS is reader specific and specified at 100 cGy dose level. This value is define per reading session and monitored over time. The KD factor was found to be different because of reading procedure are different. The ECF values changed for a group of nano dots compare to values defined based on reading done on the Microstar reader. The KL was defined for the reader. Conclusion: The new microSTARii reader presents new features that improve the efficiency of the OSLD program at the IROC HQAC. New characterization is needed before final implementation is done to match the requirements of the existing OSLD system defined for the Microstar reader. Changes in uncertainty of the results has not been analized.« less
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