title: Ability of radiation therapists to assess radiation-induced skin toxicity.
abstract: BACKGROUND
  Radiation therapy has seen enhancement of the radiation therapist (RT) role, with RTs and nurses performing duties that were traditionally in the radiation oncologist's (RO) domain. This study aimed to assess whether RTs can consistently grade radiation-induced skin toxicity and their concordance with the gradings given by ROs.
  
  
  METHODS
  Digital photographs of skin reactions were taken at weeks 1, 3 and 6 of radiotherapy on nine patients with breast cancer. The randomly ordered photographs were reviewed once by eight ROs and four RO registrars and on two occasions separated by 6 weeks by 17 RTs. All graded the skin toxicities using the revised Radiation Therapy Oncology Group system.
  
  
  RESULTS
  No significant difference was seen between the median scores of the RTs at the first scoring session and the RO/Registrar group. The RTs at both measurement times showed greater inter-rater reliability than the RO/Registrars (W = 0.6866, time 1 and 0.6981 time 2, vs. 0.6517), with the experienced RTs the most consistent (W = 0.7078). The RTs also showed high intra-rater reliability (rho = 0.8461, P < 0.0010).
  
  
  CONCLUSIONS
  These results from RTs with no specific preparation indicate that experienced RTs could assess breast cancer skin toxicity as part of their role.
authors.affiliation: Faculty of Health Science, The University of Sydney, Sydney, Australia.
authors.forename: Urvi
authors.initials: U
authors.lastname: Acharya
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cox
authors.forename: Marianne
authors.initials: M
authors.lastname: Rinks
authors.forename: Pankaj
authors.initials: P
authors.lastname: Gaur
authors.forename: Michael
authors.initials: M
authors.lastname: Back
mesh_terms: D000328:Adult; D000488:Allied Health Personnel / Q000706:statistics & numerical data*; D003951:Diagnostic Errors; D006801:Humans; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D015588:Observer Variation; D011361:Professional Competence / Q000706:statistics & numerical data*; D011855:Radiodermatitis / Q000209:etiology* / Q000473:pathology*; D020266:Radiotherapy, Conformal / Q000009:adverse effects* / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity