Virtual Radiation Oncology Peer Review is Associated with Decreased Engagement and Limited Case Discussion: Analysis of a Prospective Database Before and During the COVID-19 Pandemic
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19
Résumé en anglais
Purpose: Radiotherapy (RT) plan peer review (PR) is critical to maintain safety and quality of care in radiation oncology. During the ongoing COVID-19 pandemic, in-person activities have been limited to minimize the risk of exposure in the workplace. We aimed to determine whether the transition from an in-person to virtual format impacts the efficacy and engagement of PR conference.
Methods and Materials: We analyzed a prospectively maintained database of RT plans reviewed in routine PR between 2019-2021. Plans were categorized as in-person or virtual based on our department's transition to virtual meetings in March 2020. The rate of identified deviations and the rate and type of discussion topics per case were compared between groups.
Results: A total of 3,372 RT plans were analyzed, 1,120 in-person and 2,252 virtually. Deviations were identified in 4.1% of the cohort, significantly less for the virtual group (2.5%) compared with the in-person group (7.3%, p<0.001). PR discussion was reduced in the virtual group: 90.3% of cases had no discussion versus 72.8% in the in-person group (p<0.001). Significant decreases discussion rates for multiple topics were observed after the transition from in-person conferences to virtual PR meetings: treatment intent (2.1% to 0.7%), RT dose/prescription/technique (14.0% to 4.0%), documentation/nomenclature (4.1% to 1.3%), and target/organ at risk considerations (12.9% to 5.0%). There were no observed differences in the rates of deviations identified among cases that were discussed (26.7% in-person v. 23.9% virtual).
Conclusions: Virtual radiation oncology peer review is associated with a significant decline in identified deviations and a decrease in the frequency and breadth of discussion. Similar rates of deviations among discussed patients in either group suggest the observed change in deviation rate is potentially related to reduced physician engagement. Further evaluation of the promises and pitfalls of virtual RT plan PR is imperative.
