Attitudes and access to resources and strategies to improve quality of radiotherapy among US radiation oncologists: A mixed methods study Journal Article
| Authors: | Zhang, Y. H.; Cha, E.; Lynch, K.; Gennarelli, R.; Brower, J.; Sherer, M. V.; Golden, D. W.; Chimonas, S.; Korenstein, D.; Gillespie, E. F. |
| Article Title: | Attitudes and access to resources and strategies to improve quality of radiotherapy among US radiation oncologists: A mixed methods study |
| Abstract: | Introduction: We aimed to assess contouring-related practices among US radiation oncologists and explore how access to and use of resources and quality improvement strategies vary based on individual- and organization-level factors. Methods: We conducted a mixed methods study with a sequential explanatory design. Surveys were emailed to a random 10% sample of practicing US radiation oncologists. Participating physicians were invited to a semi-structured interview. Kruskal–Wallis and Wilcoxon rank-sum tests and a multivariable regression model were used to evaluate associations. Interview data were coded using thematic content analysis. Results: Survey overall response rate was 24%, and subsequent completion rate was 97%. Contouring-related questions arise in ≥50% of clinical cases among 73% of respondents. Resources accessed first include published atlases (75%) followed by consulting another radiation oncologist (60%). Generalists access consensus guidelines more often than disease-site specialists (P = 0.04), while eContour.org is more often used by generalists (OR 4.3, 95% CI 1.2–14.8) and younger physicians (OR 1.33 for each 5-year increase, 95% CI 1.08–1.67). Common physician-reported barriers to optimizing contour quality are time constraints (58%) and lack of access to disease-site specialists (21%). Forty percent (40%, n = 14) of physicians without access to disease-site specialists indicated it could facilitate the adoption of new treatments. Almost all (97%) respondents have formal peer review, but only 43% have contour-specific review, which is more common in academic centres (P = 0.02). Conclusion: Potential opportunities to improve radiation contour quality include improved access to disease-site specialists and contour-specific peer review. Physician time must be considered when designing new strategies. © 2022 The Royal Australian and New Zealand College of Radiologists. |
| Keywords: | adult; united states; cancer radiotherapy; cohort analysis; attitude to health; practice guideline; health care quality; questionnaire; peer review; radiation oncology; attitude; interview; health care access; radiation oncologists; radiotherapy planning; health care availability; humans; human; male; female; article; radiation oncologist; surveys and questionnaires; survey methodology; radiation contouring |
| Journal Title: | Journal of Medical Imaging and Radiation Oncology |
| Volume: | 66 |
| Issue: | 7 |
| ISSN: | 1754-9477 |
| Publisher: | John Wiley & Sons |
| Date Published: | 2022-10-01 |
| Start Page: | 993 |
| End Page: | 1002 |
| Language: | English |
| DOI: | 10.1111/1754-9485.13423 |
| PUBMED: | 35650174 |
| PROVIDER: | scopus |
| PMCID: | PMC9532345 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 November 2022 -- Source: Scopus |
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129Korenstein -
32Gennarelli -
59Chimonas -
149Gillespie -
70Lynch -
9Cha -
11Zhang
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