Evidence map›Paper›PMID 39578142›Full record

ArticleZeitschrift fur medizinische Physik2025

Systematizing the risk management process in clinical radiotherapy practice: Recommendations of the working group on risk management of the DGMP.

Dominik Kornek, Cordelia Hoinkis, Natasa Milickovic, Ailine Lange, Alena Knak, Manuel März, Mieke L Möller, Markus Buchgeister

Abstract read
In one paragraph

Article in Zeitschrift fur medizinische Physik, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

8 authors.

Dominik KornekDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany. Electronic address: dominik.kornek@tuta.io.
Cordelia HoinkisDepartment of Radiotherapy and Radiation Oncology, Faculty of Medicine University Hospital Carl Gustav Carus, Technische Universität Dresden (TUD), 01307 Dresden, Germany. Electronic address: cordelia.hoinkis@ukdd.de.
Natasa MilickovicDepartment of Medical Physics and Engineering, Radiation Oncology Clinic, Sana Klinikum Offenbach, 63069 Offenbach, Germany. Electronic address: natasa.milickovic@sana.de.
Ailine LangeMVZ Prüner Gang, 24103 Kiel, Germany. Electronic address: ailine.lange@gmx.de.
Alena KnakKlinik für Strahlentherapie, Klinikum Herford, 32049 Herford, Germany. Electronic address: alena.knak@klinikum-herford.de.
Manuel MärzDepartment of Radiotherapy, Regensburg University Medical Center, 93053 Regensburg, Germany. Electronic address: manuel.maerz@ukr.de.
Mieke L MöllerRadiologische Allianz Hamburg, 20357 Hamburg, Germany. Electronic address: mieke.moeller@radiologische-allianz.de.
Markus BuchgeisterFaculty of Mathematics-Physics-Chemistry (II), Berliner Hochschule für Technik (BHT), 13353 Berlin, Germany. Electronic address: markus.buchgeister@bht-berlin.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe Deutsche Gesellschaft für Medizinische Physik [German Society of Medical Physics] has recently published two coherent reports, No. 25 and No. 28, detailing the design and implementation of a risk management (RM) process for German radiotherapy (RT) departments. This study offers an overview and background of the efforts behind these reports. METHODS AND MATERIALS: For three years, up to nine medical physicists (MPs) with practical RM experience held weekly meetings to develop recommendations for a clinical RM process. Care was taken to ensure that the recommendations were equally applicable to RT departments of various sizes. A process-based method derived from the failure mode and effects analysis (FMEA) was created to identify and address risks from unintentional radiation exposure. This method was applied to exemplarily analyze the hazardous scenarios in breast RT using surface guidance and deep inspiration breath hold (DIBH) techniques. Three common criticality methods-risk matrix, risk priority number, and action priority-were applied, and each step was schematically explained for first-time users. Each report was peer-reviewed by two radiation oncologists and 11 MPs.

resultsIn report No. 25, basic requirements were outlined for running the RM process, conducting risk assessments, and monitoring clinical procedures. A three-year plan-do-check-act cycle was proposed for continuous improvement. In report No. 28, general process lists for external beam radiotherapy (EBRT), brachytherapy, and radionuclide therapy were designed. Based on the EBRT process list, 45 hazardous scenarios in the surface-guided breast RT in DIBH were identified. Two scenarios were used to illustrate handling instructions for the three criticality methods.

conclusionsThe recommendations provide clinical MPs and other health professionals with a pragmatic approach to RM, balancing both the needs of smaller practices and larger clinics in Germany. The risk of unintended exposures of patients is viewed acceptable once it has been lowered to a state that is as low as reasonably achievable.

Indexed as

RadiotherapyRisk ManagementGermanyHumansBest practiceFMEAPatient safetyRadiotherapyRisk management

Identifiers

PMID39578142
PMCPMC12766488

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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.