Featured Research

from universities, journals, and other organizations

Combination of existing safety checks could greatly reduce radiotherapy errors, study suggests

Date:
August 12, 2011
Source:
Johns Hopkins Medical Institutions
Summary:
A combination of several well-known safety procedures could greatly reduce patient-harming errors in the use of radiation to treat cancer, according to a new study.

A combination of several well-known safety procedures could greatly reduce patient-harming errors in the use of radiation to treat cancer, according to a new study led by Johns Hopkins researchers.

Related Articles


Radiation oncologists use more than a dozen quality assurance (QA) checks to prevent radiotherapy errors, but until now, the Hopkins researchers say, no one has systematically evaluated their effectiveness. Working with researchers at Washington University in St. Louis, the Hopkins team gathered data on about 4,000 "near miss" events that occurred during 2008-2010 at the two institutions. They then narrowed the data set to 290 events in which errors occurred that -- if they had not been caught in time -- could have allowed serious harm to patients. For each commonly used QA check, they determined the percentage of these potential patient-harming incidents that could have been prevented.

The group's key finding was that a combination of approximately six common QA measures would have prevented more than 90 percent of the potential incidents.

"While clinicians in this field may be familiar with these quality assurance procedures, they may not have appreciated how effective they are in combination," says Eric Ford, Ph.D., D.A.B.R., assistant professor of Radiation Oncology and Molecular Radiation Sciences at Johns Hopkins, who will present the group's findings on August 3 at the joint American Association of Physicists in Medicine (AAPM) and Canadian Organization of Medical Physicists annual meeting, held July 31 to August 4, 2011 in Vancouver, Canada.

At a separate symposium at the meeting, also on August 3, Ford and his colleagues will make related recommendations for the standardization of radiotherapy accident investigation procedures.

Ionizing radiation such as gamma radiation or proton beam radiation has long been a staple in cancer treatment, because it can efficiently create cell-killing DNA breaks within tumors. The goal is to use it in ways that maximize the dose delivered to a tumor, while keeping healthy tissue around the tumor as protected as possible by sharply focusing the radiation treatment area.

Unfortunately, the multistep complexity of radiation therapy, and the numerous precision measurements its use entails, can sometimes lead to mistakes, with patients getting too little radiation where it's needed, or too much where it isn't.

One QA check, a piece of hardware called an Electronic Portal Imaging Device (EPID), is built in to many radiotherapy-delivery machines, and can provide a real-time X-raylike image of the radiation coming through a patient. But Ford says less than one percent of radiotherapy clinics use EPID because the software and training needed to operate are mostly absent.

However, Ford says, their research showed that another key to safety turned out to be a humble checklist of relatively low-tech measures, "assuming it's used consistently correctly, which it often isn't," adds Ford. The checklist includes reviews of patient charts before treatment by both physicians and radiation-physicists, who calculate the right dose of radiation.

Use of film-based radiation-dose measurements as an alternative to EPID and a mandatory "timeout" by the radiation therapist before radiation is turned on to double-check that the written treatment plan and doses match what's on the radiation delivery machines were also on the list of the most effective QA procedures.

A common QA measure known as pretreatment IMRT (intensity modulated radiation therapy), in which clinical staff do a "test run" of the radiotherapy device at its programmed strength with no patient present, ranked very low on the list -- because it would have prevented almost none of the potential incidents studied. "This is important to know, because pre-treatment IMRT often consumes a lot of staff time," says Ford.

Ford and his Johns Hopkins colleague Stephanie Terezakis, M.D., a pediatric radiation oncologist and a contributor to the QA evaluation study, also are members of the AAPM Working Group on the Prevention of Errors. At the Vancouver meeting, in a symposium on August 3, the group will make recommendations for a national radiotherapy incident reporting system. The group is developing a way to have treatment errors and near-misses reported and sent to a central group for evaluation and dissemination to clinics, says Ford. "It could work in ways similar to how air and train accidents are reported to the National Transportation Safety Board," he noted.

Other experts who contributed to the QA-check effectiveness study are Kendra Harris, M.D., a radiation oncology resident at Johns Hopkins; Annette Souranis, a therapist in the radiation oncology department, and Sasa Mutic, Ph.D., associate professor of radiation oncology at Washington University School of Medicine in St. Louis, Missouri.

The study was funded with a pilot research grant from Elekta Inc.


Story Source:

The above story is based on materials provided by Johns Hopkins Medical Institutions. Note: Materials may be edited for content and length.


Cite This Page:

Johns Hopkins Medical Institutions. "Combination of existing safety checks could greatly reduce radiotherapy errors, study suggests." ScienceDaily. ScienceDaily, 12 August 2011. <www.sciencedaily.com/releases/2011/08/110803083647.htm>.
Johns Hopkins Medical Institutions. (2011, August 12). Combination of existing safety checks could greatly reduce radiotherapy errors, study suggests. ScienceDaily. Retrieved March 29, 2015 from www.sciencedaily.com/releases/2011/08/110803083647.htm
Johns Hopkins Medical Institutions. "Combination of existing safety checks could greatly reduce radiotherapy errors, study suggests." ScienceDaily. www.sciencedaily.com/releases/2011/08/110803083647.htm (accessed March 29, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Sunday, March 29, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

S. Leone in New Anti-Ebola Lockdown

S. Leone in New Anti-Ebola Lockdown

AFP (Mar. 28, 2015) Sierra Leone imposed a three-day nationwide lockdown Friday for the second time in six months in a bid to prevent a resurgence of the deadly Ebola virus. Duration: 01:17 Video provided by AFP
Powered by NewsLook.com
These Popular Antibiotics Can Cause Permanent Nerve Damage

These Popular Antibiotics Can Cause Permanent Nerve Damage

Newsy (Mar. 27, 2015) A popular class of antibiotic can leave patients in severe pain and even result in permanent nerve damage. Video provided by Newsy
Powered by NewsLook.com
WH Plan to Fight Antibiotic-Resistant Germs

WH Plan to Fight Antibiotic-Resistant Germs

AP (Mar. 27, 2015) The White House on Friday announced a five-year plan to fight the threat posed by antibiotic-resistant bacteria amid fears that once-treatable germs could become deadly. (March 27) Video provided by AP
Powered by NewsLook.com
House Ready to Pass Medicare Doc Bill

House Ready to Pass Medicare Doc Bill

AP (Mar. 26, 2015) In rare bipartisan harmony, congressional leaders pushed a $214 billion bill permanently blocking physician Medicare cuts toward House passage Thursday, moving lawmakers closer to resolving a problem that has plagued them for years. (March 26) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins