Practice patterns for peer review in radiation oncology
Practice patterns for peer review in radiation oncology
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DOI：
10.1016/j.prro.2014.04.004
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发表时间：
2015-01-01
影响因子：
3.3
通讯作者：
Marks, Lawrence B.
中科院分区：
文献类型：
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作者：
Hoopes, David J.;Johnstone, Peter A.;Marks, Lawrence B.
目的：医师同行评审旨在通过评估医师表现，特别是医疗决策和技术专业知识来提高护理质量。为了建立当前的同行评审实践模式，评估对同行评审建议的兴趣，并建立未来建议的框架，美国放射肿瘤学会 (ASTRO) 对其医生成员进行了调查。 方法和材料：开发了一种放射肿瘤学专用同行评审调查工具，经过正式测试，发现其符合既定的可靠性和有效性水平。最终的工具是使用基于网络的调查平台（包括提醒）交付的。通过电子邮件邀请全球所有 ASTRO 医师会员和培训会员参加。结果：从 2013 年 1 月开始，总共联系了 5674 名医师。总共 572 名医师参与（10%），误差范围为 +/- 4%。做出回应的人在学术机构、私人诊所和其他机构中各占一半。培训后的中位时间 = 16 年，每年新患者数量中位 = 215，诊所规模中位 = 6 名医生； 83% 的受访者参与了同行评审，75% 的受访者对他们的计划感到满意。在参与的人中，65% 的人表示在辐射开始前进行了一些审查。在这些医生治疗的患者中，56% 在治疗前接受过检查。审查的同行评审要素包括总体治疗策略（86%）、剂量和分次（89%）、轮廓（59%）以及等剂量或剂量体积直方图（75%）。由于同行评审，百分之九十的医生改变了放射计划。这些提供商在 7%-10% 的情况下会做出更改。 74% 的医生同意 ASTRO 应该提出正式的同行评审建议，7% 的人反对。结论：这项调查表明，放射肿瘤学领域的同行评审很常见，并且在相当一部分病例中导致了管理方面的变化。同行评审的进行方式和报告的效用存在很大差异。大多数 ASTRO 医生成员支持同行评审的正式建议和指导。由爱思唯尔公司代表美国放射肿瘤学会出版。
Purpose: Physician peer review seeks to improve the quality of care through the evaluation of physician performance, specifically medical decision making and technical expertise. To establish current peer review practice patterns, evaluate interest in recommendations for peer review, and establish a framework for future recommendations, the American Society for Radiation Oncology (ASTRO) surveyed its physician members.Methods and materials: A radiation oncology-specific peer review survey instrument was developed, formally tested, and found to meet established levels of reliability and validity. The final instrument was delivered using a web-based survey platform including reminders. All ASTRO physician-members and members-in-training worldwide were invited by email to participate.Results: Atotal of 5674 physicians were contacted starting in January 2013. Atotal of 572 physicians participated (10%) yielding a +/- 4% margin of error. Those responding were split evenly between academic providers and private practice and others. The median time since training = 16 years, median number of new patients per year = 215, and median practice size = 6 physicians; 83% of respondents were involved in peer review and 75% were comfortable with their program. Of those involved, 65% report doing some review before radiation begins. Of patients treated by these physicians, 56% are reviewed before treatment. Peer review elements reviewed include overall treatment strategy (86%), dose and fractionation (89%), contouring (59%), and isodose or dose-volume histogram (75%). Ninety percent of physicians have changed radiation plans because of peer review. These providers make changes in 7%-10% of cases. Seventy-four percent of physicians agree that ASTRO should make formal peer review recommendations, with 7% in opposition.Conclusions: This survey suggests that peer review in radiation oncology is common and leads to changes in management in a meaningful fraction of cases. There is much variation in the manner of conducting, and reported utility of, peer review. The majority of ASTRO physician members support formal recommendations and guidance on peer review. Published by Elsevier Inc. on behalf of American Society for Radiation Oncology.