As originally published by American College of Radiology, 2011
This research focuses on morbidity-mortality reviews and internal outcome focus studies. Definitions are provided as well as a complete discussion of the ideal parameters to consider when constructing each of these. The implementation of the design characteristics used may be of assistance to a center pursuing achievement of these requirements toward accreditation to exemplify continuous quality improvement in external-beam radiation therapy. The article further provides the educational tools necessary for readers to mature expanded studies from it for advanced site-specific clinical analyses.
Key Words: Accreditation, morbidity, mortality, outcome, rates
J Am Coll Radiol 2011;8:490-496. Copyright © 2011 American College of Radiology
This research focuses on these latter 2 primary objective areas: morbidity and mortality reviews and focused reviews of internal outcomes. Definitions are provided as well as a complete discussion of the ideal parameters to consider when constructing each of these. The implementation of design characteristics used may be of assistance to a center pursuing continuous quality improvement in externalbeam radiation therapy, which is required for accreditation to be granted by ACRO or ACR-ASTRO. The article further provides the educational tools necessary for readers to mature expanded studies from it for advanced site-specific clinical analyses.
When dealing with morbidity-mortality indices, it is important to recognize which of 3 categories are being investigated explicitly. The survival morbidity-mortality index (SMMI) indicates cancer trends for increased patient death or life retention as a result of therapy at a center and within the community. It surveys only whether patients are alive or dead. The general morbidity- mortality index (GMMI) differentiates information between patients whose ultimate fates were alive or dead into further specific categories of curative or palliative intent. The prognostic morbidity-morbidity index(PMMI) sheds light on this information, but adds more complex details to indicate whether the disease is known, unknown or whether there were complications such as death occurring as a result of the presence of disease. An internal outcome focus study can be best described as an appendix of data for the PMMI. While separating data into the categories of curative and palliative intent, it indicates which specific site of treatment is common for completing treatment regimens. It details which patients of a certain cancer type complete treatment vs those found to be incomplete as a result of death or by decision of the patient, family, or physician to stop radiation therapy. These data are site specific, outcome specific, and tabulated with prognostic design. Each of the 3 indices as well as the internal outcome focus study is presented here.
Michael Gossman, MS, DABR, RSO, is a Board Certified Qualified Expert Medical Physicist - Currently the Chief Medical Physicist & RSO of Radiation Oncology in Ashland, KY - a Medical Consultant to the U.S. Nuclear Regulatory Commission (U.S. NRC) - and an Accreditation Site Reviewer for the American College of Radiation Oncology (ACRO). He is the highest ranking scientist in the medical community. His expertise involves the safe, effective and precise delivery of radiation to achieve the therapeutic result prescribed in patient care by radiation oncologists.
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