title: A pan-Canadian survey of peer review practices in radiation oncology.
abstract: OBJECTIVE
  Peer review (PR) of treatment plans has been recognized internationally as a key component of quality care in radiation oncology programs (ROPs). We conducted a survey of Canadian ROPs to describe current PR practices and identify barriers/facilitators to PR optimization.
  
  
  METHODS
  A 42-item e-survey was sent to all Canadian ROPs (n = 44). Survey development was guided by expert consensus, literature review, and existing guidelines. One multidisciplinary response per ROP was requested.
  
  
  RESULTS
  Response rate was 100.0% (44/44). All ROPs (100.0%) reported conducting some PR and rated its importance as 7/10 or higher (10 = extremely important). One-half of ROPs (52.3%) peer-reviewed >80% of curative treatment plans. ROPs reported performing PR "always/almost always" pretreatment (38.6%) or before 25% of radiation therapy delivery (52.3%). The majority of ROPs reported recommending major plan changes in <5% of plans (88.6%) and documenting findings in the medical record (58.1%). Barriers to PR were radiation oncologist availability (34.1%) and time constraints (27.3%). Facilitators included development of PR standards (97.7%) and education/support (90.9%).
  
  
  CONCLUSIONS
  The ROPs perceive PR as highly important, but substantial variation in the extent, timing, and documentation of PR exists. The understanding of current PR activities, barriers, and facilitators will inform the development of initiatives to optimize PR in radiation oncology.
authors.affiliation: Department of Radiation Oncology, Dalhousie University, Saint John, NB, Canada.
authors.forename: Amanda
authors.initials: A
authors.lastname: Caissie
authors.affiliation: Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, ON, Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Rouette
authors.affiliation: Radiation Therapy Services, Nova Scotia Cancer Center, Halifax, NS, Canada; Department of Radiation Oncology, Dalhousie University, Halifax, NS, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Jugpal
authors.affiliation: Radiation Therapy Services, Nova Scotia Cancer Center, Halifax, NS, Canada; Department of Radiation Oncology, Dalhousie University, Halifax, NS, Canada.
authors.forename: Carol-Anne
authors.initials: CA
authors.lastname: Davis
authors.affiliation: Department of Radiation Oncology, Dalhousie University, Halifax, NS, Canada.
authors.forename: Helmut
authors.initials: H
authors.lastname: Hollenhorst
authors.affiliation: Radiation Therapy Services, Nova Scotia Cancer Center, Halifax, NS, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: O'Donnell
authors.affiliation: Canadian Partnership Against Cancer, Toronto, Canada; Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
authors.forename: Gunita
authors.initials: G
authors.lastname: Mitera
authors.affiliation: Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, ON, Canada; Department of Oncology, Queen's University, Kingston, ON, Canada. Electronic address: michael.brundage@krcc.on.ca.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Brundage
mesh_terms: D002170:Canada; D006801:Humans; D010380:Peer Review; D018787:Radiation Oncology / Q000592:standards*; D011795:Surveys and Questionnaires