Promoting the Appropriate Use of Advanced Radiation Technologies in Oncology: Summary of a National Cancer Policy Forum Workshop

Grace L. Smith, Patricia A. Ganz, Justin E. Bekelman, Steven J. Chmura, James J. Dignam, Jason A. Efstathiou, Reshma Jagsi, Peter A. Johnstone, Michael L. Steinberg, Stephen Williams, James B. Yu, Anthony L. Zietman, Ralph R. Weichselbaum, Ya Chen Tina Shih

    Research output: Contribution to journalArticle

    14 Citations (Scopus)

    Abstract

    Purpose Leaders in the oncology community are sounding a clarion call to promote “value” in cancer care decisions. Value in cancer care considers the clinical effectiveness, along with the costs, when selecting a treatment. To discuss possible solutions to the current obstacles to achieving value in the use of advanced technologies in oncology, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a workshop, “Appropriate Use of Advanced Technologies for Radiation Therapy and Surgery in Oncology” in July 2015. The present report summarizes the discussions related to radiation oncology. Methods and Materials The workshop convened stakeholders, including oncologists, researchers, payers, policymakers, and patients. Speakers presented on key themes, including the rationale for a value discussion on advanced technology use in radiation oncology, the generation of scientific evidence for value of advanced radiation technologies, the effect of both scientific evidence and “marketplace” (or economic) factors on the adoption of technologies, and newer approaches to improving value in the practice of radiation oncology. The presentations were followed by a panel discussion with dialogue among the stakeholders. Results Challenges to generating evidence for the value of advanced technologies include obtaining contemporary, prospective, randomized, and representative comparative effectiveness data. Proposed solutions include the use of prospective registry data; integrating radiation oncology treatment, outcomes, and quality benchmark data; and encouraging insurance coverage with evidence development. Challenges to improving value in practice include the slow adoption of higher value and the de-adoption of lower value treatments. The proposed solutions focused on engaging stakeholders in iterative, collaborative, and evidence-based efforts to define value and promote change in radiation oncology practice. Recent examples of ongoing or successful responses to the discussed challenges were provided. Conclusions Discussions of “value” have increased as a priority in the radiation oncology community. Practitioners in the radiation oncology community can play a critical role in promoting a value-oriented framework to approach radiation oncology treatment.

    Original languageEnglish (US)
    Pages (from-to)450-461
    Number of pages12
    JournalInternational Journal of Radiation Oncology Biology Physics
    Volume97
    Issue number3
    DOIs
    StatePublished - Mar 1 2017

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    Radiation Oncology
    cancer
    Radiation
    Technology
    Education
    radiation
    Neoplasms
    economic factors
    Benchmarking
    Insurance Coverage
    Radiation Effects
    sounding
    Registries
    medicine
    surgery
    Radiotherapy
    Therapeutics
    radiation therapy
    Economics
    Research Personnel

    ASJC Scopus subject areas

    • Radiation
    • Oncology
    • Radiology Nuclear Medicine and imaging
    • Cancer Research

    Cite this

    Promoting the Appropriate Use of Advanced Radiation Technologies in Oncology : Summary of a National Cancer Policy Forum Workshop. / Smith, Grace L.; Ganz, Patricia A.; Bekelman, Justin E.; Chmura, Steven J.; Dignam, James J.; Efstathiou, Jason A.; Jagsi, Reshma; Johnstone, Peter A.; Steinberg, Michael L.; Williams, Stephen; Yu, James B.; Zietman, Anthony L.; Weichselbaum, Ralph R.; Tina Shih, Ya Chen.

    In: International Journal of Radiation Oncology Biology Physics, Vol. 97, No. 3, 01.03.2017, p. 450-461.

    Research output: Contribution to journalArticle

    Smith, GL, Ganz, PA, Bekelman, JE, Chmura, SJ, Dignam, JJ, Efstathiou, JA, Jagsi, R, Johnstone, PA, Steinberg, ML, Williams, S, Yu, JB, Zietman, AL, Weichselbaum, RR & Tina Shih, YC 2017, 'Promoting the Appropriate Use of Advanced Radiation Technologies in Oncology: Summary of a National Cancer Policy Forum Workshop', International Journal of Radiation Oncology Biology Physics, vol. 97, no. 3, pp. 450-461. https://doi.org/10.1016/j.ijrobp.2016.10.042
    Smith, Grace L. ; Ganz, Patricia A. ; Bekelman, Justin E. ; Chmura, Steven J. ; Dignam, James J. ; Efstathiou, Jason A. ; Jagsi, Reshma ; Johnstone, Peter A. ; Steinberg, Michael L. ; Williams, Stephen ; Yu, James B. ; Zietman, Anthony L. ; Weichselbaum, Ralph R. ; Tina Shih, Ya Chen. / Promoting the Appropriate Use of Advanced Radiation Technologies in Oncology : Summary of a National Cancer Policy Forum Workshop. In: International Journal of Radiation Oncology Biology Physics. 2017 ; Vol. 97, No. 3. pp. 450-461.
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    abstract = "Purpose Leaders in the oncology community are sounding a clarion call to promote “value” in cancer care decisions. Value in cancer care considers the clinical effectiveness, along with the costs, when selecting a treatment. To discuss possible solutions to the current obstacles to achieving value in the use of advanced technologies in oncology, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a workshop, “Appropriate Use of Advanced Technologies for Radiation Therapy and Surgery in Oncology” in July 2015. The present report summarizes the discussions related to radiation oncology. Methods and Materials The workshop convened stakeholders, including oncologists, researchers, payers, policymakers, and patients. Speakers presented on key themes, including the rationale for a value discussion on advanced technology use in radiation oncology, the generation of scientific evidence for value of advanced radiation technologies, the effect of both scientific evidence and “marketplace” (or economic) factors on the adoption of technologies, and newer approaches to improving value in the practice of radiation oncology. The presentations were followed by a panel discussion with dialogue among the stakeholders. Results Challenges to generating evidence for the value of advanced technologies include obtaining contemporary, prospective, randomized, and representative comparative effectiveness data. Proposed solutions include the use of prospective registry data; integrating radiation oncology treatment, outcomes, and quality benchmark data; and encouraging insurance coverage with evidence development. Challenges to improving value in practice include the slow adoption of higher value and the de-adoption of lower value treatments. The proposed solutions focused on engaging stakeholders in iterative, collaborative, and evidence-based efforts to define value and promote change in radiation oncology practice. Recent examples of ongoing or successful responses to the discussed challenges were provided. Conclusions Discussions of “value” have increased as a priority in the radiation oncology community. Practitioners in the radiation oncology community can play a critical role in promoting a value-oriented framework to approach radiation oncology treatment.",
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    AU - Dignam, James J.

    AU - Efstathiou, Jason A.

    AU - Jagsi, Reshma

    AU - Johnstone, Peter A.

    AU - Steinberg, Michael L.

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