Evidence map›Paper›PMID 33089020›Full record

ArticleAdvances in radiation oncology

A Risk-Adjusted Control Chart to Evaluate Intensity Modulated Radiation Therapy Plan Quality.

Arkajyoti Roy, Dan Cutright, Mahesh Gopalakrishnan, Arthur B Yeh, Bharat B Mittal

Open access · goldAbstract read
In one paragraph

Article in Advances in radiation oncology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 17 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Arkajyoti RoyDepartment of Management Science and Statistics, University of Texas at San Antonio, San Antonio, Texas.
Dan CutrightDepartment of Radiation Oncology, University of Chicago Medical Center, Chicago, Illinois.
Mahesh GopalakrishnanDepartment of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Arthur B YehDepartment of Applied Statistics and Operations Research, Bowling Green State University, Bowling Green, Ohio.
Bharat B MittalDepartment of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Northwestern University · USBowling Green State University · USThe University of Texas at San Antonio · USUniversity of Chicago Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aimed to develop a quality control framework for intensity modulated radiation therapy plan evaluations that can account for variations in patient- and treatment-specific risk factors. METHODS AND MATERIALS: Patient-specific risk factors, such as a patient's anatomy and tumor dose requirements, affect organs-at-risk (OARs) dose-volume histograms (DVHs), which in turn affects plan quality and can potentially cause adverse effects. Treatment-specific risk factors, such as the use of chemotherapy and surgery, are clinically relevant when evaluating radiation therapy planning criteria. A risk-adjusted control chart was developed to identify unusual plan quality after accounting for patient- and treatment-specific risk factors. In this proof of concept, 6 OAR DVH points and average monitor units serve as proxies for plan quality. Eighteen risk factors are considered for modeling quality: planning target volume (PTV) and OAR cross-sectional areas; volumes, spreads, and surface areas; minimum and centroid distances between OARs and the PTV; 6 PTV DVH points; use of chemotherapy; and surgery. A total of 69 head and neck cases were used to demonstrate the application of risk-adjusted control charts, and the results were compared with the application of conventional control charts.

resultsThe risk-adjusted control chart remains robust to interpatient variations in the studied risk factors, unlike the conventional control chart. For the brainstem, the conventional chart signaled 4 patients with unusual (out-of-control) doses to 2% brainstem volume. However, the adjusted chart did not signal any plans after accounting for their risk factors. For the spinal cord doses to 2% brainstem volume, the conventional chart signaled 2 patients, and the adjusted chart signaled a separate patient after accounting for their risk factors. Similar adjustments were observed for the other DVH points when evaluating brainstem, spinal cord, ipsilateral parotid, and average monitor units. The adjustments can be directly attributed to the patient- and treatment-specific risk factors.

conclusionsA risk-adjusted control chart was developed to evaluate plan quality, which is robust to variations in patient- and treatment-specific parameters.

Identifiers

PMID33089020
PMCPMC7560572
OpenAlexW2993907785

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.