Evidence map›Paper›PMID 34712606›Full record

ArticleFrontiers in oncology2021

Variations in Head and Neck Treatment Plan Quality Assessment Among Radiation Oncologists and Medical Physicists in a Single Radiotherapy Department.

Elisabetta Cagni, Andrea Botti, Linda Rossi, Cinzia Iotti, Mauro Iori, Salvatore Cozzi, Marco Galaverni, Ala Rosca, Roberto Sghedoni, Giorgia Timon and 2 more

Abstract read
In one paragraph

Article in Frontiers in oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Uncertainties in outcome modelling in radiation oncology.Physics and imaging in radiation oncology · 2025
    Review
  5. Article
  6. Article
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

12 authors.

Elisabetta CagniMedical Physics Unit, Azienda Unità Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico (USL-IRCCS) di Reggio Emilia, Reggio Emilia, Italy.
Andrea BottiMedical Physics Unit, Azienda Unità Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico (USL-IRCCS) di Reggio Emilia, Reggio Emilia, Italy.
Linda RossiDepartment of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands.
Cinzia IottiRadiotherapy Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Mauro IoriMedical Physics Unit, Azienda Unità Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico (USL-IRCCS) di Reggio Emilia, Reggio Emilia, Italy.
Salvatore CozziRadiotherapy Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Marco GalaverniRadiotherapy Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Ala RoscaRadiotherapy Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Roberto SghedoniMedical Physics Unit, Azienda Unità Sanitaria Locale Istituto di Ricovero e Cura a Carattere Scientifico (USL-IRCCS) di Reggio Emilia, Reggio Emilia, Italy.
Giorgia TimonRadiotherapy Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Emiliano SpeziSchool of Engineering, Cardiff University, Cardiff, United Kingdom.
Ben HeijmenDepartment of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAgreement between planners and treating radiation oncologists (ROs) on plan quality criteria is essential for consistent planning. Differences between ROs and planning medical physicists (MPs) in perceived quality of head and neck cancer plans were assessed. MATERIALS AND

methodsFive ROs and four MPs scored 65 plans for in total 15 patients. For each patient, the clinical (CLIN) plan and two or four alternative plans, generated with automated multi-criteria optimization (MCO), were included. There was always one MCO plan aiming at maximally adhering to clinical plan requirements, while the other MCO plans had a lower aimed quality. Scores were given as follows: 1-7 and 1-2, not acceptable; 3-5, acceptable if further planning would not resolve perceived weaknesses; and 6-7, straightway acceptable. One MP and one RO repeated plan scoring for intra-observer variation assessment.

resultsFor the 36 unique observer pairs, the median percentage of plans for which the two observers agreed on a plan score (100% = 65 plans) was 27.7% [6.2, 40.0]. In the repeat scoring, agreements between first and second scoring were 52.3% and 40.0%, respectively. With a binary division between unacceptable (scores 1 and 2) and acceptable (3-7) plans, the median inter-observer agreement percentage was 78.5% [63.1, 86.2], while intra-observer agreements were 96.9% and 86.2%. There were no differences in observed agreements between RO-RO, MP-MP, and RO-MP pairs. Agreements for the highest-quality, automatically generated MCO plans were higher than for the CLIN plans.

conclusionsInter-observer differences in plan quality scores were substantial and could result in inconsistencies in generated treatment plans. Agreements among ROs were not better than between ROs and MPs, despite large differences in training and clinical role. High-quality automatically generated plans showed the best score agreements.

Indexed as

automated treatment planninghead and neck cancerinter-observer and intra-observer variationradiotherapy treatment planningsubjective plan quality assessment

Identifiers

PMID34712606
PMCPMC8545894

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