title: International radiation oncology trainee decision making in the management of radiotherapy-induced nausea and vomiting.
abstract: OBJECTIVE
  This study explored international radiation oncology trainee decision making in the management of radiotherapy-induced nausea and vomiting (RINV).
  
  
  METHODS
  Radiation oncology trainees who were members of the national radiation oncology associations of the USA, Canada, Netherlands, Australia, New Zealand, France, Spain and Singapore completed a Web-based survey. Respondents estimated the risks of nausea and vomiting associated with six standardised radiotherapy-only clinical case vignettes modelled after international anti-emetic guidelines and then committed to prophylactic, rescue or no therapy as an initial management approach for each case.
  
  
  RESULTS
  One hundred and seventy-six trainees from 11 countries responded. Only 28 % were aware of any anti-emetic guideline. In general, risk estimates and management approaches for the high-risk and minimal risk cases varied less and were more in line with guideline standards than were estimates and approaches for the moderate- and low-risk cases. Prophylactic therapy was the most common approach for the high-risk and a moderate-risk case (83 and 71 % of respondents respectively), while rescue therapy was the most common approach for a second moderate-risk case (69 %), two low-risk cases (69 and 76 %) and a minimal risk case (68 %). A serotonin receptor antagonist was the most commonly recommended prophylactic agent. On multivariate analysis, a higher estimated risk of nausea predicted for recommending prophylactic therapy, and a lower estimated risk of nausea predicted for recommending rescue therapy.
  
  
  CONCLUSIONS
  Radiation oncology trainee risk estimates and recommended management approaches for RINV clinical case vignettes varied and matched guideline standards more often for high-risk and minimal risk cases than for moderate- and low-risk cases. Risk estimates of nausea specifically were strong predictors of management decisions.
authors: Ottawa Hospital Research Institute, Division of Radiation Oncology, The Ottawa Hospital Cancer Centre & University of Ottawa, Ottawa, Ontario, Canada.
authors: Kristopher
authors: K
authors: Dennis
authors: Liying
authors: L
authors: Zhang
authors: Stephen
authors: S
authors: Lutz
authors: Yvette
authors: Y
authors: van der Linden
authors: Angela
authors: A
authors: van Baardwijk
authors: Tanya
authors: T
authors: Holt
authors: Jean-Leon
authors: JL
authors: Lagrange
authors: Palmira
authors: P
authors: Foro-Arnalot
authors: Lea-Choung
authors: LC
authors: Wong
authors: Ernesto
authors: E
authors: Maranzano
authors: Kam-Hung
authors: KH
authors: Wong
authors: Rico
authors: R
authors: Liu
authors: Vassilios
authors: V
authors: Vassiliou
authors: Benjamin W
authors: BW
authors: Corn
authors: Carlo
authors: C
authors: De Angelis
authors: Lori
authors: L
authors: Holden
authors: C Shun
authors: CS
authors: Wong
authors: Edward
authors: E
authors: Chow
mesh_terms: D000932:Antiemetics / Q000009:adverse effects / Q000627:therapeutic use; D003625:Data Collection; D003657:Decision Making; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D015999:Multivariate Analysis; D009325:Nausea / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control; D009369:Neoplasms / Q000532:radiotherapy*; D017410:Practice Guidelines as Topic; D011832:Radiation Injuries / Q000209:etiology*; D018787:Radiation Oncology / Q000193:education*; D018570:Risk Assessment / Q000592:standards*; D012702:Serotonin Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D014839:Vomiting / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control
chemical_list: D000932:Antiemetics; D012702:Serotonin Antagonists