Navigation Links
Two-step decision tree analysis helps inform updates of RT best practices, quality standards
Date:7/28/2014

Fairfax, Va., July 28, 2014A two-step decision tree analysis, incorporating Donabedian's model, is a feasible process to evaluate and distill the many available quality standards, guidelines, recommendations and indicators in order to update national and international quality standards for radiation therapy, according to a study published in the July-August 2014 issue of Practical Radiation Oncology (PRO), the official clinical practice journal of the American Society for Radiation Oncology (ASTRO).

Guidelines, recommendations and indicators may be utilized to develop new "best practice" standards through a formal consensus process and evaluation of the evidence base. The appropriate requirements and criteria for redeveloped standards, however, are not as well defined. This study, "Quality standards in radiation medicine," was designed to identify and validate an appropriate approach to collate, catalogue and analyze existing quality standards. A two-step decision tree method allows for the organization of numerous different standards issued by a range of national and international organizations and identifies duplicate standards as well as gaps in the standards.

Quality-related documents were identified using Google Scholar and Discover and three selection criteria: 1) national or international; 2) contain statements or questions related to measuring quality in a broad sense in radiation medicine programs; and 3) written in English. Technical quality control standards were not included in this analysis. From this analysis, eight publicly available documents were used to identify 454 radiation therapy quality standards or groups of standards. Each of the five study authors completed two exercises to categorize the 454 identified standards to Donabedian's structure, process or outcome, and also to the target of the standard: patients, staff, equipment or clinical process, or organization, for a total of 12 primary categories.

In exercise one, the 454 standards were categorized using a two-step process. The first step was to categorize the standards according to the Donabedian model, which provides a framework for examining health services and evaluating quality of care using three categories: structure, process and outcome. This categorization resulted in groups of approximately 150 standards each, making an in-depth analysis difficult. To reduce the size of the groups, a second step was implemented to classify the 454 standards according to each standard's target group (patients, staff, equipment or clinical process, or organization). This two-step process resulted in 12 primary classifications with an average size of 40 standards. The resulting smaller group size helped in identifying duplicate standards and key quality measures. The evaluators' responses were examined for reliability using the Fleiss free marginal kappa. The agreement between the evaluators was fair (k from 0.21 to 0.40) or moderate (k from 0.41 to 0.60), meaning three or more reviewers assigned the same categories in both steps to 67 percent (304) of the 454 quality standards. In the Donabedian model step, three or more evaluators agreed on the classification for 93 percent (422) of the 454 standards.

A second exercise was conducted, to determine if greater consistency in categorizations could be achieved. The evaluators reassessed any standards that did not receive unanimous categorization (n=290) in the first exercise. The standards were again categorized using the Donabedian model. When the 290 reevaluations were combined with the 164 that received unanimous agreement in exercise one, the free marginal kappa improved to 0.71, which shows substantial agreement (k=0.61 to 0.80). In exercise two, 64 percent (290) were classified as structure, 26 percent (116) were classified for process, and 10 percent (45) were classified for outcome.

"This research provides a sound basis for refining the global approach to improving quality and safety in radiation therapy. Although there is no agreed upon 'best practice' to use as the basis for revising standards, the methodology used in our study may be helpful for organizations interested in a formal consensus process for revising documents," said Peter Dunscombe, PhD, of the University of Calgary in Calgary, Alberta, and co-author of the study. "The analysis has already influenced refinement of the Canadian Partnership for Quality Radiotherapy's Quality Assurance Guidance for Canadian Radiation Treatment Programs guideline document, supporting the CPQR's work in further enhancing the high standards of Canadian radiation therapy treatment."


'/>"/>

Contact: Michelle Kirkwood
press@astro.org
703-286-1600
American Society for Radiation Oncology
Source:Eurekalert

Related medicine news :

1. Venapro: Two-Step All-Natural Hemorrhoids Treatment Formula Now Available With 1 Extra Bottle Offer
2. 2 Courts, 2 Different Decisions on Key Obamacare Provision
3. LawyersandSettlements.com Interviews Attorney Roy Pollack About The Recent Microsoft Wrongful Termination Lawsuit Decision for the Plaintiff in Texas
4. To accept or not accept -- Patients want a say in liver transplant decisions
5. Study finds diagnosing physicians influence therapy decisions for prostate cancer patients
6. Madison-based SWAMP, Secure Decisions partner to enhance software security
7. The Lancet Neurology: Post-concussion return to play decision for footballers should be made solely by doctors, says new editorial
8. Mobile Device Forensics Guidelines Play Key Role in Supreme Court’s Smartphone Evidence Warrant Decision
9. Shared decision making during radiation therapy improves patient satisfaction
10. Ever-so-slight delay improves decision-making accuracy
11. Social norms strongly influence vaccination decisions and the spread of disease
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... ... June 24, 2016 , ... June 19, 2016 is World ... with chronic pain and the benefits of holistic treatments, Serenity Recovery Center ... with Sickle Cell Disease. , Sickle Cell Disease (SCD) is a disorder of the ...
(Date:6/24/2016)... ... June 24, 2016 , ... Global law firm Greenberg Traurig, ... Elite. The attorneys chosen by their peers for this recognition are considered among the ... Traurig Shareholders received special honors as members of this year’s Legal Elite Hall of ...
(Date:6/24/2016)... ... ... Inc, makers of Topricin and MyPainAway Pain Relief Products, join The ‘Business for a Fair ... hour by 2020 and then adjusting it yearly to increase at the same rate as ... the wage floor does not erode again, and make future increases more predictable. , The ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... ... Living, is proud to recognize Dr. Barry M. Weintraub as a prominent plastic ... most beautiful women in the world, and the most handsome men, look naturally ...
(Date:6/24/2016)... ... , ... National recruitment firm Slone Partners is pleased to announce ... experience, as Vice President of North American Capital Sales at HTG Molecular . ... sales team in the commercialization of the HTG EdgeSeq system and associated reagents in ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Research and Markets has announced the addition ... Chemical (Sugar, Petrochemical, Glycerin), Inorganic Chemical), Functionality (Filler, Binder, ... Forecast to 2021" report to their offering. ... excipients market is projected to reach USD 8.1 Billion ... forecast period 2016 to 2021. The ...
(Date:6/23/2016)... Research and Markets has announced the ... 2016 - Forecast to 2022" report to their offering. ... up to date financial data derived from varied research sources ... with potential impact on the market during the next five ... comprises of sub markets, regional and country level analysis. The ...
(Date:6/23/2016)... WAYNE, Pa. , June 23, 2016 ... provider, will launch its next generation clinical outcomes platform, Bracket ... DIA Meeting held on June 26 – 30, 2016 in ... 6.0, the first electronic Clinical Outcome Assessment product of its ... DIA Booth #715. Bracket eCOA 6.0 is a ...
Breaking Medicine Technology: