在形束计算机断层扫描基于在线自适应性辐射疗法期间作业决策的安全性和效率分析
Lawrence M Wong1, Mikel Byrne2, Erik van Dieren3
1Department of Radiation Medicine & Applied Sciences, University of California, San Diego, La Jolla, California.
International journal of radiation oncology, biology, physics
|February 16, 2024
概括
在线适应性辐射疗法 (ART) 的实施需要仔细考虑人类的决策,以确保安全性和效率. 优化ART程序包括减少对支持人员的依赖,提高控制台工作人员的技能,包括解决认知偏见.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 临床决策 临床决策
背景情况:
- 基于形束计算断层扫描 (CBCT) 的在线自适应性辐射疗法 (ART) 对具有实质性断层解剖变化的患者提供了显著的好处.
- 控制台上的实时治疗规划和审查可能会带来安全风险和效率低下,特别是当委托给常规范围之外的员工时.
研究的目的:
- 系统地分析在线自适应性辐射疗法 (ART) 会议期间人类决策的安全性和效率影响.
- 确定基于CBCT的在线ART的实施中潜在的风险和改进领域.
主要方法:
- 系统理论过程分析技术的应用,包括对人类决策的扩展.
- 由来自四个中心的团队进行的分析,具有基于CBCT的多种在线ART实践模型.
主要成果:
- 完善放射治疗控制结构,以模拟例行和辅助人员之间的相互作用.
- 治疗提供人员确定了6个关键控制行动,其中18个不良状态影响安全和/或效率.
- 发现了97个危险的临床场景,其中"划分/编辑影响者和目标结构"构成最大的风险.
结论:
- 最佳安全和高效的在线ART程序应该尽量减少治疗控制台的支持人员,以减少协调问题.
- 控制台工作人员的培训至关重要,包括轮编辑,最佳计划选择和克服识别的认知偏见的策略.
- 技术和组织的变化是成功在线ART实施的必要补充人员培训.
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