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American Association of Physicists in Medicine Task Group 263: Standardizing Nomenclatures in Radiation Oncology.

ABSTRACT: A substantial barrier to the single- and multi-institutional aggregation of data to supporting clinical trials, practice quality improvement efforts, and development of big data analytics resource systems is the lack of standardized nomenclatures for expressing dosimetric data. To address this issue, the American Association of Physicists in Medicine (AAPM) Task Group 263 was charged with providing nomenclature guidelines and values in radiation oncology for use in clinical trials, data-pooling initiatives, population-based studies, and routine clinical care by standardizing: (1) structure names across image processing and treatment planning system platforms; (2) nomenclature for dosimetric data (eg, dose-volume histogram [DVH]-based metrics); (3) templates for clinical trial groups and users of an initial subset of software platforms to facilitate adoption of the standards; (4) formalism for nomenclature schema, which can accommodate the addition of other structures defined in the future. A multisociety, multidisciplinary, multinational group of 57 members representing stake holders ranging from large academic centers to community clinics and vendors was assembled, including physicists, physicians, dosimetrists, and vendors. The stakeholder groups represented in the membership included the AAPM, American Society for Radiation Oncology (ASTRO), NRG Oncology, European Society for Radiation Oncology (ESTRO), Radiation Therapy Oncology Group (RTOG), Children's Oncology Group (COG), Integrating Healthcare Enterprise in Radiation Oncology (IHE-RO), and Digital Imaging and Communications in Medicine working group (DICOM WG); A nomenclature system for target and organ at risk volumes and DVH nomenclature was developed and piloted to demonstrate viability across a range of clinics and within the framework of clinical trials. The final report was approved by AAPM in October 2017. The approval process included review by 8 AAPM committees, with additional review by ASTRO, European Society for Radiation Oncology (ESTRO), and American Association of Medical Dosimetrists (AAMD). This Executive Summary of the report highlights the key recommendations for clinical practice, research, and trials.

SUBMITTER: Mayo CS

PROVIDER: S-EPMC7437157 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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American Association of Physicists in Medicine Task Group 263: Standardizing Nomenclatures in Radiation Oncology.

Mayo Charles S CS Moran Jean M JM Bosch Walter W Xiao Ying Y McNutt Todd T Popple Richard R Michalski Jeff J Feng Mary M Marks Lawrence B LB Fuller Clifton D CD Yorke Ellen E Palta Jatinder J Gabriel Peter E PE Molineu Andrea A Matuszak Martha M MM Covington Elizabeth E Masi Kathryn K Richardson Susan L SL Ritter Timothy T Morgas Tomasz T Flampouri Stella S Santanam Lakshmi L Moore Joseph A JA Purdie Thomas G TG Miller Robert C RC Hurkmans Coen C Adams Judy J Jackie Wu Qing-Rong QR Fox Colleen J CJ Siochi Ramon Alfredo RA Brown Norman L NL Verbakel Wilko W Archambault Yves Y Chmura Steven J SJ Dekker Andre L AL Eagle Don G DG Fitzgerald Thomas J TJ Hong Theodore T Kapoor Rishabh R Lansing Beth B Jolly Shruti S Napolitano Mary E ME Percy James J Rose Mark S MS Siddiqui Salim S Schadt Christof C Simon William E WE Straube William L WL St James Sara T ST Ulin Kenneth K Yom Sue S SS Yock Torunn I TI

International journal of radiation oncology, biology, physics 20171215 4

A substantial barrier to the single- and multi-institutional aggregation of data to supporting clinical trials, practice quality improvement efforts, and development of big data analytics resource systems is the lack of standardized nomenclatures for expressing dosimetric data. To address this issue, the American Association of Physicists in Medicine (AAPM) Task Group 263 was charged with providing nomenclature guidelines and values in radiation oncology for use in clinical trials, data-pooling ...[more]

PMID: 29485047

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Project description:Background and purposeThe professional quality of life of radiation oncology professionals can be influenced by different contributing factors, including personality traits. Alexithymia involves deficits in emotion processing and awareness. Empathy is the ability to understand another's 'state of mind/emotion'. We investigated professional quality of life, including burnout, in radiation oncology, exploring the role of alexithymia and empathy and targeting the population of medical physicists (MPs), since this professional category is usually underrepresented in surveys exploring professional well-being in radiation oncology and MPs may experience professional distress given the increasing complexity of multimodal cancer care.Material and methodsAn online survey was addressed to ESTRO members. Participants filled out three questionnaires to evaluate alexithymia, empathy and professional quality of life: a) Toronto Alexithymia Scale (TAS-20); b) Interpersonal Reactivity Index (IRI); c) Professional Quality of Life Scale (ProQoL). Professional quality of life as per ProQoL was considered as dependent variable. The three domains of the ProQoL, namely compassion satisfaction (CS), secondary traumatic stress (STS) and burnout were correlated with alexithymia (as per TAS-20) and empathy (as per IRI with three subcategories: empathic concern, perspective taking and personal distress) and demographic/professional characteristics as independent variables. Generalized linear modeling was used. Significant covariates on univariate linear regression analysis were included in the multivariate linear regression model.ResultsA total of 308 medical physicists completed all questionnaires. Alexithymia as per TAS-20 was correlated to decreased CS (β = -0.25, p < 0 0.001), increased likelihood for STS (β = 0.26, p < 0 0.001) and burnout (β = 0.47, p < 0 0.001). With respect to empathy, the 'Empatic Concern' subscale of the IRI was found to be a significant predictor for increased CS (β = 0.19, p = 0 0.001) and increased STS (β = 0.19, p < 0 0.001), without significant correlation with burnout. The individual's perception of being valued by own's supervisor was correlated to increased CS (β = 0.23, p < 0.001), and decreased burnout (β = -0.29, p < 0.001).ConclusionsAlexithymic personality trait increased the likelihood to develop burnout, with less professional satisfaction amongst MPs working in radiation oncology. Empathy results in higher professional fulfilment. These results may be used to benchmark preventing strategies, including peer support, debriefing sessions, leadership initiatives and work-load limitation strategies.

Project description:PurposeThe impact of the COVID-19 pandemic on Latin American radiation therapy services has not yet been widely assessed. In comparison to centers in Europe or the United States, the scarcity of data on these terms might impair design of adequate measures to ameliorate the pandemic's potential damage. The first survey-based analysis revealing regional information is herein presented.Methods and materialsFrom May 6 to May 30, 2020, the American Society for Radiation Oncology's COVID-19 Survey was distributed across Latin America with support of the local national radiation therapy societies. Twenty-six items, including facility demographic and financial characteristics, personnel and patient features, current and expected impact of the pandemic, and research perspectives, were included in the questionnaire.ResultsComplete responses were obtained from 115 (50%) of 229 practices across 15 countries. Only 2.6% of centers closed during the pandemic. A median of 4 radiation oncologists (1-27) and 9 (1-100) radiation therapists were reported per center. The median number of new patients treated in 2019 was 600 (24-6200). A median 8% (1%-90%) decrease in patient volume was reported, with a median of 53 patients (1-490) remaining under treatment. Estimated revenue reduction was 20% or more in 53% of cases. Shortage of personal protective equipment was reported in 51.3% of centers, and 27% reported personnel shortage due to COVID-19. Reported delays in treatment for low-risk entities included early stage breast cancer (42.6%), low-risk status prostate cancer (67%), and nonmalignant conditions (42.6%). Treatment of COVID-19 patients at designated treatment times and differentiated bunkers were reported in 22.6% and 10.4% of centers, respectively. Telehealth initiatives have been started in 64.3% of facilities to date for on-treatment (29.6%) and posttreatment (34.8%) patients.ConclusionsRegional information regarding COVID-19 pandemic in Latin America may help elucidate suitable intervention strategies for personnel and patients. Follow-up surveys will be performed to provide dynamic monitoring the pandemic's impact on radiation therapy services and adoption of ameliorating measures.

Project description:PurposeTo assess US radiation oncologists' views on practice scope and the ideal role of the radiation oncologist (RO), the American Society for Radiation Oncology (ASTRO) conducted a scope of practice survey.Methods and materialsIn spring 2019, ASTRO distributed an online survey to 3822 US RO members. The survey generated 984 complete responses (26% response rate) for analysis. Face validity testing confirmed respondents were representative of ASTRO's RO membership.ResultsNearly all respondents agreed that "ROs should be leaders in oncologic care." Respondents indicated the ideal approach to patient care was to provide "an independent opinion on radiation therapy and other treatment options" (82.5%) or "an independent opinion on radiation therapy but not outside of it" (16.1%), with only 1.4% favoring provision of "radiation therapy at the request of the referring physician" as the ideal approach. Actual practice fully matched the ideal approach in 18.2% of respondents. For the remaining majority, actual practice did not always match the ideal and comprised a mix of approaches that included providing radiation at the referring physician's request 24.0% of the time on average. Reasons for the mismatch included fear of alienating referring physicians and concern for offering an unwelcome opinion. One-fifth of respondents expressed a desire to expand the scope of service though interspecialty politics and insufficient training were potential barriers. Respondents interested in expanding scope of practice were on average earlier in their career (average years in practice 13.3) than those who were not interested (average years in practice 17.2, P < .001). Radiopharmaceuticals administration, medical marijuana and anticancer medications prescribing, and RO inpatient service represented areas of interest for expansion but also knowledge gaps.ConclusionsThese results provide insight regarding US ROs' scope of practice and attitudes on the ideal role of the RO. For most ROs, to provide an independent opinion on treatment options represented the ideal approach to care, but barriers such as concern of alienating referring physicians prevented many from fully adhering to their ideal in practice. Actual practice commonly comprised a mixed approach, including the least favored scenario of delivering radiation at the referring physician's request one-quarter of the time, highlighting the influence of interspecialty politics on practice behavior. Advocacy for open communication and meaningful interdisciplinary collaboration presents an actionable solution toward a more balanced relationship with other specialties as ROs strive to better fulfill the vision of being leaders in oncologic care and being our best for our patients. The study also identified interest in expanding into nontraditional domains that offer opportunities to address unmet needs in the cancer patient's journey and elevate radiation oncology within the increasingly value-based US health care system.

Project description:PurposeTo prepare for big data analyses on radiation therapy data, we developed Stature, a tool-supported approach for standardization of structure names in existing radiation therapy plans. We applied the widely endorsed nomenclature standard TG-263 as the mapping target and quantified the structure name inconsistency in 2 real-world data sets.Methods and materialsThe clinically relevant structures in the radiation therapy plans were identified by reference to randomized controlled trials. The Stature approach was used by clinicians to identify the synonyms for each relevant structure, which was then mapped to the corresponding TG-263 name. We applied Stature to standardize the structure names for 654 patients with prostate cancer (PCa) and 224 patients with head and neck squamous cell carcinoma (HNSCC) who received curative radiation therapy at our institution between 2007 and 2017. The accuracy of the Stature process was manually validated in a random sample from each cohort. For the HNSCC cohort we measured the resource requirements for Stature, and for the PCa cohort we demonstrated its impact on an example clinical analytics scenario.ResultsAll but 1 synonym group ("Hydrogel") was mapped to the corresponding TG-263 name, resulting in a TG-263 relabel rate of 99% (8837 of 8925 structures). For the PCa cohort, Stature matched a total of 5969 structures. Of these, 5682 structures were exact matches (ie, following local naming convention), 284 were matched via a synonym, and 3 required manual matching. This original radiation therapy structure names therefore had a naming inconsistency rate of 4.81%. For the HNSCC cohort, Stature mapped a total of 2956 structures (2638 exact, 304 synonym, 14 manual; 10.76% inconsistency rate) and required 7.5 clinician hours. The clinician hours required were one-fifth of those that would be required for manual relabeling. The accuracy of Stature was 99.97% (PCa) and 99.61% (HNSCC).ConclusionsThe Stature approach was highly accurate and had significant resource efficiencies compared with manual curation.

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American Association of Physicists in Medicine Task Group 263: Standardizing Nomenclatures in Radiation Oncology.

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American Association of Physicists in Medicine Task Group 263: Standardizing Nomenclatures in Radiation Oncology.

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