Evidence map›Paper›PMID 35125328›Full record

Trial reportBrachytherapy

A comparative study using time-driven activity-based costing in single-fraction breast high-dose rate brachytherapy: An integrated brachytherapy suite vs. decentralized workflow.

Gabriella C Squeo, Courtney M Lattimore, Nicole L Simone, Greg Suralik, Sunil W Dutta, Michael D Schad, Lucy Su, Bruce Libby, Einsley-Marie Janowski, Shayna L Showalter and 2 more

Open access · greenAbstract readClinical Trial, Phase IIMulticenter Study
In one paragraph

Trial report in Brachytherapy. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 32% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
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 at 2 institutions in 1 country.

Gabriella C SqueoDivision of Breast and Melanoma Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA.
Courtney M LattimoreDivision of Breast and Melanoma Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA.
Nicole L SimoneDepartment of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA.
Greg SuralikDepartment of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA.
Sunil W DuttaDepartment of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA.
Michael D SchadDepartment of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA.
Lucy SuDepartment of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA.
Bruce LibbyDepartment of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA.
Einsley-Marie JanowskiDepartment of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA.
Shayna L ShowalterDivision of Breast and Melanoma Surgery, Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA.
Jennifer M LoboDepartment of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA.
Timothy N ShowalterDepartment of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA. Electronic address: tns3b@virginia.edu.
University of Virginia · USThomas Jefferson University · US

Funding

Women's Oncology Program - WONP30CA044579 · NCI · UNIVERSITY OF VIRGINIA CHARLOTTESVILLE · PI Thomas P. Loughran · 1987 to 2026
$72.1M
Postdoctoral Training Grant for MDs in Surgical Oncology ResearchT32CA163177 · NCI · UNIVERSITY OF VIRGINIA · PI Craig Lee Slingluff, Allan Tsung · 2011 to 2026
$4.6M
Evaluation of image-guided, conformal, high-dose intraoperative radiation therapy (Precision Breast IORT) for early stage breast cancerR01CA214594 · NCI · UNIVERSITY OF VIRGINIA · PI SHOWALTER, SHAYNA LEFRAK, SHOWALTER, TIMOTHY NORMAN · 2018 to 2022
$1.9M
NCI NIH HHS P30 CA044579NCI NIH HHS R01 CA214594NCI NIH HHS T32 CA163177
6 · The paper itself

Abstract

introductionPrecision breast intraoperative radiation therapy (PB-IORT) is a novel approach to adjuvant radiation therapy for early-stage breast cancer performed as part of a phase II clinical trial at two institutions. One institution performs the entire procedure in an integrated brachytherapy suite which contains a CT-on-rails imaging unit and full anesthesia capabilities. At the other, breast conserving surgery and radiation therapy take place in two separate locations. Here, we utilize time-driven activity-based costing (TDABC) to compare these two models for the delivery of PB-IORT.

methodsProcess maps were created to describe each step required to deliver PB-IORT at each institution, including personnel, equipment, and supplies. Time investment was estimated for each step. The capacity cost rate was determined for each resource, and total costs of care were then calculated by multiplying the capacity cost rates by the time estimate for the process step and adding any additional product costs.

resultsPB-IORT costs less to deliver at a distributed facility, as is more commonly available, than an integrated brachytherapy suite ($3,262.22 vs. $3,996.01). The largest source of costs in both settings ($2,400) was consumable supplies, including the brachytherapy balloon applicator. The difference in costs for the two facility types was driven by personnel costs ($1,263.41 vs. $764.89). In the integrated facility, increased time required by radiation oncology nursing and the anesthesia attending translated to the greatest increases in cost. Equipment costs were also slightly higher in the integrated suite setting ($332.60 vs. $97.33).

conclusionsThe overall cost of care is higher when utilizing an integrated brachytherapy suite to deliver PB-IORT. This was primarily driven by additional personnel costs from nursing and anesthesia, although the greatest cost of delivery in both settings was the disposable brachytherapy applicator. These differences in cost must be balanced against the potential impact on patient experience with these approaches.

Indexed as

BrachytherapyBreast NeoplasmsFemaleHumansMastectomy, SegmentalWorkflowBreast cancerCt-on-railsHigh dose-rate brachytherapyIntegrated brachytherapy suiteIntraoperative radiation therapyTime-driven activity-based costing

Identifiers

PMID35125328
PMCPMC9149052
OpenAlexW4210352699

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.