Compensation for radiotherapy treatment interruptions due to a cyberattack: An isoeffective DVH-based dose compensation decision tool.

Unscheduled interruptions to radiotherapy treatments lead to decreased tumor control probability (TCP). Rapid cell repopulation in the tumor increases due to the absence of radiation dose, resulting in the loss of TCP. Compensation for this loss is required to prevent or reduce an extension of the patient's overall treatment time and regain the original TCP. The cyberattack on the Irish public health service in May 2021 prevented radiotherapy treatment delivery resulting in treatment interruptions of up to 12 days. Current standards for treatment gap calculations are performed using the Royal College of Radiologists (RCR) methodology, using a point-dose for planning target volume (PTV) and the organs at risk (OAR). An in-house tool, named EQD2 VH, was created in Python to perform treatment gap calculations using the dose-volume histogram (DVH) information in DICOM data extracted from commercial treatment planning system plans. The physical dose in each dose bin was converted into equivalent dose in 2-Gy fractions (EQD2 ), accounting for tumor cell repopulation. This EQD2 -based DVH provides a 2D representation of the impact of treatment gap compensation strategies on both PTV and OAR dose distributions compared to the intended prescribed treatment plan. This additional information can aid clinicians' choice of compensation options. EQD2 VH was evaluated using five high-priority patients experiencing a treatment interruption when the cyberattack occurred. Compensation plans were created using the RCR methodology to evaluate EQD2 VH as a decision-making tool. The EQD2 VH method demonstrated that the comparison of compensated treatment plans alongside the original intended treatment plans using isoeffective DVH analysis can be achieved. It enabled a visual and quantitative comparison between treatment plan options and provided an individual analysis of each structure in a patient's plan. It demonstrated potential to be a useful decision-making tool for finding a balance between optimizing dose to PTV while protecting OARs.

Cross-cultural validation of the IRB Researcher Assessment Tool: Chinese Version.

BACKGROUND: Using an effective method for evaluating Institutional Review Board (IRB) performance is essential for ensuring an IRB's effectiveness, efficiency, and compliance with applicable human research standards and organizational policies. Currently, no empirical research has yet been published in China evaluating IRB performance measures by the use of a standardized tool. This study was therefore conducted to develop a Chinese version of the IRB Researcher Assessment Tool (IRB-RAT), assess the psychometric properties of the Chinese version (IRB-RAT-CV), and validate the tool for use in China. METHODS: In this cultural adaptation, cross-sectional validation study, the IRB-RAT-CV was developed through a back-translation process and then distributed to 587 IRB staff members and researchers in medical institutions and schools in Hunan Province that review biomedical and social-behavioral research. Data from the 470 valid questionnaires collected from participants was used to evaluate the reliability, content validity, and construct validity of the IRB-RAT-CV. RESULTS: Participants' ratings of their ideal and actual IRB as measured by the IRB-RAT-CV achieved Cronbach's alpha 0.989 and 0.992, Spearman-Brown coefficient 0.964 and 0.968, and item-total correlation values ranging from 0.631 to 0.886 and 0.743 to 0.910, respectively. CONCLUSION: The IRB-RAT-CV is a linguistically and culturally applicable tool for assessing the quality of IRBs in China.

The Impact of Demographic Characteristics on Awareness and Usage of Support Groups.

There are support groups established for one's emotional and/or physical health; as a result, marketing has appeared in regards to the needs, benefits, and hesitations regarding these groups. This study addresses several types of individuals and situations that lend themselves to using support groups. The authors conducted a study designed to examine demographic characteristics as they relate to a person's decision to go to support groups for health conditions. Looking at the demographics of users and the types of support groups, the authors discuss diverse opportunities for support groups and their organizations to promote communication, improve marketing strategies, and create influential users.

Sensitivity of volumetric modulated arc therapy patient specific QA results to multileaf collimator errors and correlation to dose volume histogram based metrics.

PURPOSE: This study investigates the impact of systematic multileaf collimator (MLC) positional errors on gamma analysis results used for quality assurance (QA) of Rapidarc treatments. In addition, this study evaluates the relationship of these gamma analysis results and clinical dose volume histogram metrics (DVH) for Rapidarc treatment plans. METHODS: Five prostate plans were modified by the introduction of systematic MLC errors. The MLC shifts to each individual active leaf introduced were 0.25, 0.5, 0.75, and 1 mm. All QA verification plans were delivered and estimated 3D patient dose or high density phantom dose were obtained based on the ArcCHECK measurement files. QA gamma analysis of 3%/3 mm and 2%/2 mm were implemented and relationships to dose differences in DVH metrics encountered due to MLC errors were determined. Tolerances of 3% and 5% for DVH metric were implemented to determine the sensitivity of gamma analysis to MLC errors. A calculation of sensitivity was determined from the number of incidences of false negative and false positive cases in gamma analysis results. RESULTS: The sensitivity of global gamma analysis for criteria of 3%/3 mm was 0.78 and for 2%/2 mm was 0.82. A number of instances occurred for an acceptable VMAT QA gamma index which did not indicate a DVH metric dose error greater than 5%. The correlation between global gamma analysis using criteria 3%/3 mm and DVH metric dose error were all <0.8 indicating less than a strong correlation. CONCLUSIONS: There is a greater sensitivity for detection of dosimetric errors occurring in a Rapidarc plan using gamma criteria of 2%/2 mm than 3%/3 mm. However, there is lack of consistently strong correlation between global gamma indexes and clinical DVH metrics for PTV and bladder and rectum for Rapidarc plans. It is recommended that the sole use of gamma index for Rapidarc QA plan evaluation could be insufficient and a methodology for evaluation of delivered dose to patient is required.