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Table 6 Recommended steps for improvement and/or harmonization for selected indicators/processes

From: Multicentre clinical radiotherapy audit in rectal cancer: results of the IROCA project

PROCESS OR INDICATOR FINDING RECOMMENDED ACTION
DIAGNOSTIC AND PRE-TREATMENT PHASE
Presentation to MTB 75.6% of cases presented to MTB (range, 50–95%). Present all cases to MTB
Implement quality control measures to ensure registration of data in 100% of cases
Presentation at departmental clinical session 63.8% of cases presented Establish clear criteria for presenting cases to clinical sessions
Consider using mini-tumour boards comprised of radiation oncologists specialising in the specific tumour type/location
Staging MRI 67.0% of cases (range, 10.3 to 95%) Implement measures to raise MRI-based staging to 100%
Participation in clinical trial 6.3% (range, 0 to 25%) At centres with low rates, seek to increase the percentage of patients participating in clinical trials
TREATMENT PHASE
Median time between biopsy and first visit to RT 37.6 days (range, 21.6–58.6) Implement measures to reduce this time interval
Median time elapsed between first visit and start of radiotherapy 22 days (range, 15.1–38.8) Implement measures to reduce this time interval
Treatment interruptions 43.9% of cases (EBRT), range 2.5–90% Implement measures to reduce interruptions at centres with a high percentage of treatment interruptions
Consider working on Saturdays and holidays
Treatment compensation rates 2.1% of cases compensated (range, 0 to 100%)
Data not registered in some cases
Implement measures to increase compensation rates
Apply quality control measures to ensure registration of data in 100% of cases
Treatment completed in prescribed time 55.7% of treatments completed in prescribed time ± 4 days (range, 10–97.5%) Apply procedures to raise rate to 100%
Consider working on Saturdays and holidays
FOLLOW-UP PHASE
Registration of AEs missing Data missing in 11.2% of cases Implement quality control measures to ensure registration of data in 100% of cases
  1. Abbreviations: MTB, multidisciplinary tumour board; MRI, magnetic resonance imaging; AE, adverse events; RT, radiotherapy