Analysis of Virtual Versus In-Person Prospective Peer Review Workflow in a Multisite Academic Radiation Oncology...

Area of Science:

• Radiation oncology
• Medical physics
• Healthcare management

Background:

• Peer review is crucial for assessing subjective treatment planning decisions in radiation oncology.
• The COVID-19 pandemic necessitated a shift from in-person to virtual peer review workflows.
• Assessing the impact of this transition on the quality and efficiency of peer review is essential.

Purpose of the Study:

• To compare virtual versus in-person prospective peer review in radiation oncology.
• To evaluate differences in timeliness and plan deviation rates between the two modalities.

Main Methods:

• Prospective peer review of 274 in-person plans (2017-2018) and 195 virtual plans (2021).
• Evaluation of treatment intent, contour definition, target coverage, and critical structure risk using planning software.
• Definition of deviation as any suggested plan revision.

Main Results:

• No significant difference in the time from simulation to treatment start (9.2 vs 10.0 days).
• Significant reduction in overall deviations in virtual peer review (8.0% in-person vs 2.6% virtual).
• Significant difference observed in palliative intent cases (36% vs 22%).

Conclusions:

• Virtual prospective peer review of radiation oncology treatment plans is feasible with comparable timeliness to in-person reviews.
• The reduced deviation rate in virtual peer review warrants further investigation.
• The potential for virtual workflow to become a standard of care requires additional study.