Wake Forest University Medical Center Winston Salem, NC, United States
M. Farris1, R. T. Hughes2, N. Razavian2, A. C. Snavely3, C. L. Nightingale4, E. G. Wood4, M. D. Mix5, E. C. Daugherty6, E. McTyre7, A. Goetz2, J. C. Farris8, J. Vogel8, G. J. Lesser9, and K. E. Weaver10; 1Department of Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, NC, 2Department of Radiation Oncology, Wake Forest University School of Medicine, Winston Salem, NC, 3Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston Salem, NC, 4Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston Salem, NC, 5SUNY Upstate Medical University, Syracuse, NY, 6Department of Radiation Oncology, University of Cincinnati Cancer Center, Cincinnati, OH, 7Prisma Health Radiation Oncology, Greenville, SC, 8Department of Radiation Oncology, Bon Secours Health System, Greenville, SC, 9Department of Hematology and Oncology, Wake Forest University School of Medicine, Winston Salem, NC, 10Department of Social Sciences and Health Policy, Winston Salem, NC
Purpose/Objective(s): Peer review (PR) is a critical component of radiation oncology practice, but the methods by which this is carried out are highly variable. There has been a substantial change in the format and structure of inter- and intra-disciplinary meetings with the recent rise in virtual/hybrid teleconferencing. We surveyed NCI National Community Oncology Research Program (NCORP) sites to better understand the format, structure, and content of radiation oncology PR. Materials/
Methods: A one-time survey was distributed to ROs across 42 NCORP community sites through the Wake Forest NCORP Research Base (UG1CA189824) between January and February 2024. The survey explored the routine PR practices of radiation oncologists. Results: Twenty-eight radiation oncologists from 13 NCORP sites, all indicated that they participate in routine PR. Years of practice were 0-5 in 25%, 6-10 years in 36%, and >10 years in 39%. The frequency of PR meetings was weekly in 22 of 26, daily in 2, and every other week in 2. The participants were limited to radiation oncologists at all responding practices; no practices included interdisciplinary collaboration with radiologists in their PR. The format of PR was a hybrid of in-person/virtual at 13 practices, virtual only (no in-person/hybrid option) at 10, in-person only (no virtual/hybrid option) at 4, with 1 not reported. Six practices reported using some form of asynchronous PR (PR performed independently without the treating physician). The timing of PR was reported by 27 and included after treatment planning is complete (n=19), after contouring but before plan creation/dose calculation (n=2), and a mix of both (n=6). For those reporting a mix of PR timing, the median percent of cases that underwent PR before dose calculation was 15% (range: 5-60) with the remaining 85% (range: 40-95) reviewed after plan completion. Components of the plans subject to PR (reported as the number reviewing each component, out of the 28 respondents) included contours (23), targets/organs at risk (25), dose distributions (26), dose-volume histograms (26), prescription dose/fractionation (27), diagnostic imaging (12), pathology data (13), and treatment intent (23). Other components reviewed included informed consent (1) and morbidity and mortality conference (1). Conclusion: Peer review in radiation oncology is a universal practice with more heterogeneity in the meeting format than is in the content reviewed. Most practices are performing PR after treatment planning is complete. Additional focus on the timing and format of radiotherapy plan PR is necessary to develop best practices to optimize safety and ensure comprehensive PR.
