ArticleJournal of applied clinical medical physics2025
Systems-theoretic process analysis of a CT-guided online adaptive radiation therapy system in a multi-vendor environment.
Article in Journal of applied clinical medical physics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
- Systems-theoretic process analysis of a CT-guided online adaptive radiation therapy system in a multi-vendor environment.Journal of applied clinical medical physics · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOnline adaptive radiation therapy (ART) is a relatively new process, and it is recommended that institutions starting an online ART program conduct a risk analysis to identify potential hazards. While Failure Modes and Effects Analysis (FMEA) is common, Systems-Theoretic Process Analysis (STPA) has also been used to evaluate online ART workflows. PURPOSE: An STPA hazard analysis was performed for a CT-guided online ART system in a multi-vendor environment. The goal was to identify potential risks and mitigations to guide the development of adaptive workflows and the quality management (QM) program.
methodsThe STPA hazard analysis was performed in four steps. First, process maps for online ART were generated to describe the interactions between users and systems. In the second step, the process maps were refined to a single control structure diagram model. In the third step, potential unsafe control actions (UCAs) were enumerated by the physicists involved in the analysis. Finally, mitigation strategies to address the UCAs were identified.
resultsA total of 496 UCAs were identified for 119 control actions, of which 239 (48.2%) were prioritized for mitigation due to having low or medium levels of detectability. The most frequent causal scenarios were accidental omission (20.1%), rushing (17.2%), and lack of training (15.9%). The most common consequences were delays (26.8%) and having to repeat work (13.5%). The two mitigation strategies considered to address the most causal scenarios were requiring trained adaptive staff (28.9%) and having physics oversight (19.9%).
conclusionsThe STPA led to valuable insights into the potential causes of unsafe control actions and various mitigation strategies that were used to develop the QM program. Notably, most UCAs were attributable to interactions between users and the system, rather than system failures. It is recommended that every institution starting an online ART program perform a risk assessment for their environment.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.