Best practice guidelines for use of reference points in radiation oncology information systems to aggregate longitudinal dosimetric data

Alon Witztum; Younes Jourani; Emily Y Hirata; Todd McNutt; Thomas G Purdie; Kristy K Brock; David S Hong; Michelle E Howard; Andra V Krauze; Peter A Balter; Abigail L Stockham; Elizabeth Covington; Ying Xiao; Richard Popple; Charles S Mayo

doi:10.1016/j.prro.2024.09.016

Best practice guidelines for use of reference points in radiation oncology information systems to aggregate longitudinal dosimetric data

Pract Radiat Oncol. 2024 Nov 12:S1879-8500(24)00300-X. doi: 10.1016/j.prro.2024.09.016. Online ahead of print.

Authors

Affiliations

¹ University of California, Department of Radiation Oncology, San Francisco, USA. Electronic address: [email protected].
² Institut Jules Bordet, Medical Physics Department, Brussels, Belgium.
³ University of California, Department of Radiation Oncology, San Francisco, USA.
⁴ Johns Hopkins University, Department of Radiation Oncology and Molecular Radiation Sciences, Baltimore, USA.
⁵ Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Canada.
⁶ The University of Texas MD Anderson Cancer Center, Department of Imaging Physics, Houston, USA.
⁷ University of Southern California, Department of Radiation Oncology, Los Angeles, USA.
⁸ University of Iowa, Department of Radiation Oncology, Iowa City, USA.
⁹ National Cancer Institute, NIH, Radiation Oncology Branch, Center for Cancer Research, Bethesda, USA.
¹⁰ Mayo Clinic, Department of Radiation Oncology, Rochester, USA.
¹¹ University of Michigan, Department of Radiation Oncology, Ann Arbor, USA.
¹² University of Pennsylvania, Department of Radiation Oncology, Philadelphia, USA.
¹³ University of Alabama at Birmingham, Medical Physics Division, Birmingham, USA.

PMID: 39542396
DOI: 10.1016/j.prro.2024.09.016

Abstract

Purpose/objectives: Tracking patient dose in radiation oncology is challenging due to disparate electronic systems from various vendors. Treatment planning systems (TPS), radiation oncology information systems (ROIS), and electronic health records (EHR) lack uniformity, complicating dose tracking and reporting. To address this, we examined practices in multiple radiation oncology settings and proposed guidelines for current systems.

Material/methods: A survey was conducted among members of various professional groups to understand dose reporting practices in TPS, ROIS, and EHR systems. The aim was to identify consistent components and develop guidelines.

Results: We identified six treatment scenarios where current ROIS defaults fail in accurately representing dose totals. A standardized approach involving three reference point types - Primary Treatment Plan Reference, Dose Check, and Prescription Tracking - was proposed to address these scenarios. Standardizing naming conventions for reference points was also recommended for easier integration with EHRs. The approach requires minimal modifications to existing systems and facilitates easier data transfer and display in EHRs.

Conclusion: Standardizing reference points in commercial TPS and ROIS can bridge infrastructure gaps and improve dose tracking in complex clinical scenarios. This standardization, aligned with AAPM's TG-263, paves the way for continual development of automated, standardized, interoperable tools, enhancing the ease of sharing reference point information.