Reinstein L E, Peachey S, Laurie F, Glicksman A S
Int J Radiat Oncol Biol Phys. 1985 Jun;11(6):1179-84. doi: 10.1016/0360-3016(85)90067-7.
The impact of a quality assurance program on protocol compliance has been explored. A sample of 2258 patients, who received radiation therapy on 18 different NCI funded protocols, was selected for this study from the more than 6200 cases reviewed by the Quality Assurance Review Center (QARC) from 1974 to 1983. Analysis of this sample reveals a significant decrease in the protocol non-compliance rate as a function of QA participation time (35% down to 5%). The educational impact of the QA program is demonstrated by the drop in the protocol dose deviation rate from 11.4% (before QARC feedback) to 3.6% (after feedback, p less than .001). The corresponding drop in protocol deviations in treatment volume is from 21.5% to 10.5% (p less than .001). The effect of the "on-treatment" review process is studied; it is demonstrated that this process cuts the rate of major deviations in half. The technical discrepancies in dose are also analyzed and discussed.
一项质量保证计划对方案依从性的影响已得到探讨。从1974年至1983年质量保证审查中心（QARC）审查的6200多例病例中，选取了2258例接受18种不同的美国国立癌症研究所（NCI）资助方案放射治疗的患者作为本研究的样本。对该样本的分析显示，方案不依从率随质量保证参与时间显著下降（从35%降至5%）。质量保证计划的教育影响表现为方案剂量偏差率从11.4%（QARC反馈前）降至3.6%（反馈后，p小于0.001）。治疗体积方面方案偏差相应地从21.5%降至10.5%（p小于0.001）。对“治疗中”审查过程的效果进行了研究；结果表明该过程将主要偏差率降低了一半。还对剂量方面的技术差异进行了分析和讨论。
