title: ASTRO APEx®and RO-ILS™ are applicable to medical malpractice in radiation oncology.
abstract: OBJECTIVE
  To analyze malpractice trials in radiation oncology and assess how ASTRO APEx®and RO-ILS™ apply to such cases.
  
  
  METHODS
  The Westlaw database was reviewed using PICOS/PRISMA methods. Fisher's exact and Mann-Whitney U tests were used to find factors associated with outcomes.
  
  
  RESULTS
  Of 34 cases identified, external beam was used in 26 (77%). The most common factors behind malpractice were excessive toxicity (80%) and lack of informed consent (66%). ASTRO APEx pillars and ROI-LS had applicability to all but one case. Factors favoring the defendant included statute of limitations (odds ratio: 8.1; 95% CI: 1.3-50); those favoring the plaintiff included patient death (odds ratio: 0.7; 95% CI: 0.54-0.94).
  
  
  CONCLUSIONS
  APEx and RO-ILS are applicable to malpractice trials in radiation oncology.
authors.affiliation: Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Zaorsky
authors.affiliation: Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Ricco
authors.affiliation: Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Churilla
authors.affiliation: Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Horwitz
authors.affiliation: Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Den
mesh_terms: D006801:Humans; D008318:Malpractice / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000453:epidemiology / Q000532:radiotherapy*; D018787:Radiation Oncology / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D011878:Radiotherapy / Q000009:adverse effects*
keywords: cancer; healthcare; malpractice; quality assurance; radiation oncology; safety