Developing an IT infrastructure for the National Radiation Oncology Registry.

A systematic quality assurance framework for the upgrade of radiation oncology information systems

PurposeRegularly collected patient-reported outcome measures (PROMs) can facilitate early symptom detection and improve health outcomes. This explorative analysis aimed to investigate PROM adherence and factors associated with daily PROM completion among pediatric cancer patients.MethodsWe analyzed data from a prospective study at the Medical University of Innsbruck in which pediatric patients with cancer treated with chemotherapy completed daily PROMs via a web-based portal (ePROtect). We analyzed the PROM adherence during their first year of treatment descriptively and using a linear mixed model to evaluate factors associated with PROM adherence.ResultsFifty patients (42% female) with a median age of 10.7 years (IQR 7.1–15.4) were included in this analysis (analysis period 05/2020 to 05/2023). The mean adherence was 48.7% (SD 27.2), with the highest adherence during the first 30 days (77.1%). Significant predictive factors for lower adherence included time in the program (logarithmic; β = -0.093, p < 0.001) and admission to the intensive care unit (β = -0.224, p < 0.001). In contrast, inpatient stays (β = 0.035, p = 0.014) and self-reported pain (β = 0.087, p = 0.002) were significant predictors for higher PROM adherence. Occurrences of adverse events were not significantly associated with adherence.DiscussionOur findings suggest that continuous daily symptom monitoring is feasible over extended periods. PROM adherence stabilized over time despite an initial drop, with higher participation observed during inpatient stays and in weeks with self-reported pain. Future research should explore and evaluate strategies to improve adherence.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11136-025-04002-0.

IntroductionInflammatory bowel disease is characterised by remission and flare. Flares of IBD are common and often require unscheduled care. However, OPD slots can become filled with stable, diarised appointments which...

Patient-reported Outcomes After External Beam Radiotherapy With Low Dose Rate Brachytherapy Boost vs Radical Prostatectomy for Localized Prostate Cancer: Five-year Results From a Prospective Comparative Effectiveness Study.

Collaborating with the Community: Improving Patient Access to Palliative Radiation Therapy

425 Background: Prostate cancer (PC) ranks among the most prevalent cancers in men, with incidence rising due to factors like aging populations and enhanced screening techniques. Effective data extraction from clinical records is crucial for advancing research and improving patient care; however, traditional manual methods can be time-consuming and susceptible to mistakes. This study seeks to evaluate RadOnc-GPT against human annotation for extracting essential clinical information from prostate cancer clinical records. Methods: RadOnc-GPT is a retrieval augmented generation (RAG)-based chatbot with access to a variety of patient data including treatment details, radiology reports, and clinical notes. RadOnc-GPT uses Open AI’s gpt-4o model. Patients who received curative intent radiotherapy as initial treatment for PC in our institution between 2014 and 2023 were randomly selected for evaluation. Relevant Clinical factors were extracted by a human expert annotator on our on-site RedCap database. The extraction of the same variables was performed using RadOnc-GPT. A comparison between the ground truth (human annotation) and RadOnc-GPT, to evaluate the performance of the AI system, was carried out including accuracy, recall and F1 score. Results: A total of 382 PC patients were included in the cohort for data extraction. The clinical variables extracted were the treatment intent, NCCN risk category, T and N stage, Gleason score, radiation volume, and Androgen Deprivation therapy (ADT) use. The overall performance of RadOnc-GPT was excellent, with the highest accuracy achieved for treatment intent (99.7%), Gleason score (98.4%), and Treatment Volume (90.1-99.5%). Conclusions: RadOnc-GPT performed excellent at extracting relevant clinical details from the electronic medical record and radiation oncology information systems with dramatic reduction in time and cost compared with manual review. LLMs could be highly useful for large-scale data extraction in PC research, offering a promising solution for automating the accurate data extraction process. Correct (n) Total (n) Accuracy Recall F1 score RT with curative intent 381 382 99.7 99.9 99.9 Prostate Cancer Risk Category 345 382 90.3 90.4 95.1 Primary tumor staging (T) at diagnosis 368 382 96.3 96.3 97.9 Regional nodal status (N) at diagnosis 352 382 92.1 92.2 95.9 Gleason Score Primary Secondary Total 376372376 382382382 98.497.498.4 98.597.498.5 99.298.799.2 Treated Areas Prostate Pelvic Nodes Para-Aortic Nodes Distant Site 380344378372 382382382382 99.590.19997.4 99.490.199.197.4 99.79599.598.7 ADT Use with RT 365 382 95.5 95.7 97.8

Process and Systems: A population-based model of care for people with inflammatory bowel disease – patient-reported outcomes

342 Background: Patient-reported outcomes (PROs) assess a patient’s self-reported health status, including disease symptoms, treatment experience, functional outcomes, and quality of life. Incorporation of PROs has been linked to improved patient symptom control and increased shared decision making. Standardized PRO measures (PROMs) are becoming more frequent as an endpoint for clinical trials, however their use is less frequent in routine care for patients with cancer. The goal of this study was to assess the utilization of PROMs and identify barriers to their use. Methods: US-licensed oncologists/hematologists convened at one of three live meetings in 2023 to review recent clinical updates. Respondent demographics were collected ahead via an online survey. During the meetings, participants responded to queries on their use and perceptions of PROs and PROMs. Responses were captured via audience response system technology; not all participants answered every question. Pooled data were summarized using descriptive statistics. Results: Of the 146 respondents, 77.4% self-identified as community-setting providers, spent 84.3% of their time seeing patients, saw an average of 19.8 patients/day, and averaged 17.7 years of experience. Respondents found PROs to be most useful in early detection/management of treatment toxicities and symptoms (63.8%) and tailoring of clinical/supportive care (56%). The majority of PROs are typically recorded through informal verbal inquiries, while 18.1% and 10.9% of respondents use validated and non-validated PROMs, respectively. Few respondents (11.3%) administer PROMs to every patient at every visit, while over one-third (38.3%) never administer PROMs. Within the practice, medical assistants and nurses are most likely to be the provider administering PROMs. PROMs are most commonly administered when the patient is in the office and are infrequently administered through other means. Lack of time to administer or review PRO surveys (45.1%), and lack of reimbursement (38.9%) and EMR integration (38.9%) were the most common reported barriers to using PROMs in the respondents’ practices. Conclusions: Despite the majority of respondents finding PROs useful in practice, a minority use formal measures to record PROs. Further, usage is infrequent across patient visits. Lack of time, lack of reimbursement, and logistic barriers are the most common reasons for not using PROMs in routine care. These barriers may be overcome by efforts or guideline changes from regulatory agencies, payors, or clinical guideline organizations. Future work will assess how physicians are using PROMs in treatment selection for their patients with cancer.

Systemwide Implementation of Patient-Reported Outcomes in Routine Clinical Care at a Children's Hospital

In order to improve the efficiency of patient care, we developed an electronic medical record system, named the Comprehensive Radiation Oncology Management System (C-ROMS). C-ROMS was used together with a commercial record-and-verify system, LANTIS (Siemens Medical Systems Inc., Concord, CA, USA). The impact of the C-ROMS/LANTIS system on the staff workload in the Radiation Oncology Department was quantified and evaluated. Thirty-four breast cancer patients were divided into two groups based on the method of the charting and the delivery of radiation treatment. The paper chart and manual treatment were used for one group, and the C-ROMS/LANTIS for the other. For each group of patients, the workload per patient for each staff group in the department-nursing/clerical staff, simulation staff, dosimetry/physics staff and technologist staff-was measured and compared. The average total staff workload with the C-ROMS/LANTIS system was 28.2% less than that with the paper chart/manual treatment method. The workloads for nursing/clerical staff, simulation staff and technologist staff were reduced by 85.7, 61.2 and 20.6%, respectively. The workload for dosimetry/physics staff was increased by 28.4%. The C-ROMS/LANTIS system significantly decreased the averaged total staff workload, and thus increased the efficiency of patient care.

Correlation of Patient-Reported Outcomes Measurement Information System (PROMIS) scores with legacy patient-reported outcome scores in patients undergoing rotator cuff repair

BackgroundAccurate identification of the tumor bed after breast-conserving surgery (BCS) ensures appropriate radiation to the tumor bed while minimizing normal tissue exposure. The BioZorb® three-dimensional (3D) bioabsorbable tissue marker provides a reliable target for radiation therapy (RT) planning and follow-up evaluation while serving as a scaffold to maintain breast contour.MethodsAfter informed consent, 818 patients (826 breasts) implanted with the BioZorb® at 14 U.S. sites were enrolled in a national registry. All the patients were prospectively followed with the BioZorb® implant after BCS. The data collected at 3, 6, 12, and 24 months included all demographics, treatment parameters, and provider/patient-assessed cosmesis.ResultsThe median follow-up period was 18.2 months (range, 0.2–53.4 months). The 30-day breast infection rate was 0.5 % of the patients (n = 4), and re-excision was performed for 8.1 % of the patients (n = 66), whereas 2.6 % of the patients (n = 21) underwent mastectomy. Two patients (0.2 %) had local recurrence. The patient-reported cosmetic outcomes at 6, 12, and 24 months were rated as good-to-excellent by 92.4 %, 90.6 %, and 87.3 % of the patients, respectively and similarly by the surgeons. The radiation oncologists reported planning of target volume (PTV) reduction for 46.2 % of the patients receiving radiation boost, with PTV reduction most commonly estimated at 30 %.ConclusionsThis report describes the first large multicenter study of 818 patients implanted with the BioZorb® tissue marker during BCS. Radiation oncologists found that the device yielded reduced PTVs and that both the patients and the surgeons reported good-to-excellent long-term cosmetic outcomes, with low adverse effects. The BioZorb® 3D tissue marker is a safe adjunct to BCS and may add benefits for both surgeons and radiation oncologists.

Development of a model web-based system to support a statewide quality consortium in radiation oncology

The patient's quality of life is an integral part of the evaluation of anticancer treatment. We can meet its evaluation mainly within the framework of clinical studies and research projects, but it is increasingly included in routine clinical practice as well. In radiotherapy, this indicator needs to be evaluated especially with the advent of new fractionation regimes, which are supposed to ensure better clinical results, but also the same or better quality of life for patients compared to another fractionation scheme. There are several ways to measurably evaluate the quality of life. Questionnaires filled in by patients are most often used, so this is a subjective approach. It is essential to choose the right methodology, especially the type and form of questionnaires with regard to the specific situation (diagnosis, treatment, etc.). In this educational review article, quality of life and its role in the treatment of a patient with radiotherapy are defined. Next, selected methods of quality of life assessment in radiotherapy are described in detail. Emphasis is placed especially on available questionnaire surveys, generic or specific. Among the most commonly used quality of life questionnaires are those from the EORTC group, FACIT questionnaires and the EQ-5D, SF-36, WHOQOL-100 and WHOQOL-BREF questionnaires. The general EORTC QLQ-C30 questionnaire, which is also often used in radiotherapy, is used to demonstrate the assessment on one specific example of a questionnaire completed by a patient. The quality of life of an oncology patient ranks among the most important evaluations of care outcomes (patient reported outcomes measures), and data collection for its evaluation should be part of routine clinical practice in radiation oncology as well, especially when introducing a new fractionation regimen. The purpose of this educational review article is to point out the various possibilities for evaluating the quality of life, different types of generic and specific questionnaires, and also to emphasize certain recommendations and procedures necessary for quality evaluation of questionnaires.

Purpose: To establish a practical, step-by-step algorithm for trauma-informed tattooing that structures shared decision-making, reduces retraumatization risk, and improves patient-reported outcomes (PROs) in both studio and clinical contexts. Methodology: Peer-reviewed literature (2011–2025) on medical and decorative tattooing, psychodermatology, and trauma-informed care was synthesized. The evidence was translated into a procedural workflow with phase-specific checklists and monitoring metrics, including a PRO-focused screening kit and implementation indicators for continuous quality improvement. Findings: The reviewed evidence indicates that medical and reconstructive tattooing can improve satisfaction, body image, and quality of life, with low complication rates when aseptic technique and standard follow-up are used. Trauma-informed implementation is strengthened by a structured, consent-paced approach that expands client choice and control. The resulting algorithm comprises seven phases: pre-screening, environment setup, needs and goals mapping, layered informed consent, co-design with a pain plan, aseptic procedure with micro-pauses, individualized aftercare, and referral pathways. The accompanying PRO kit includes 7- and 30-day satisfaction and distress screening, along with implementation indicators to support ongoing quality improvement. Unique Contribution to Theory, Policy and Practice: This work operationalizes trauma-informed, client-centered tattooing into an actionable workflow that studios and clinical services can adopt immediately. It advances theory by linking trauma-informed principles to observable procedural steps, supports policy by proposing measurable safeguards (checklists, PRO monitoring, referral criteria), and strengthens practice by providing standardized tools that improve consistency, safety, and real-world sustainability while defining priorities for staff training and future research.