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Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System

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Published on: April 11, 2018

Navigating Variability in Prostate RT Planning: Real-Time Insights for Human-Centered CDS Design.

Meagan Foster¹, Elizabeth Byrd^1,2, Elizabeth Kwong^1,2

¹Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC, United States.

AMIA ... Annual Symposium Proceedings. AMIA Symposium

|February 23, 2026

Summary

This summary is machine-generated.

Radiation oncologists adapt to prostate radiation therapy (RT) planning variability through individual interpretation and adaptive strategies. Findings inform the design of context-sensitive clinical decision support (CDS) tools.

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Area of Science:

Medical Physics
Radiation Oncology
Human Factors Engineering

Background:

Clinical variability in prostate radiation therapy (RT) planning is a known issue.
Understanding the human factors behind this variability is crucial for improving treatment consistency.
Little is known about how radiation oncologists experience and adapt to factors driving planning variability.

Purpose of the Study:

To explore variability in prostate RT planning as a human-centered design challenge.
To inform the design of clinical decision support (CDS) tools by gaining real-time insight into planning decisions.
To identify contributors to variability from the perspective of radiation oncologists.

Main Methods:

Conducted observation sessions using the think-aloud method with five radiation oncologists during prostate case contouring.
Followed observations with semi-structured interviews to gather in-depth insights.
Thematically analyzed contributors to variability using the Systems Engineering Initiative for Patient Safety (SEIPS) framework across tasks, technology, and organizational conditions.

Main Results:

Variability in prostate RT planning stems from anatomical ambiguity, guideline interpretation, and individual decision-making.
Radiation oncologists employ adaptive strategies, including reliance on prior experience and estimation under uncertainty.
Factors contributing to variability were identified across tasks, technology, and organizational contexts.

Conclusions:

Variability in prostate radiation therapy planning is influenced by complex cognitive and adaptive processes of radiation oncologists.
Context-sensitive CDS tools are needed to support clinical reasoning while maintaining flexibility.
Human-centered design approaches are essential for developing effective decision support in radiation oncology.