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Article
Publication date: 1 December 1981

J.W.N. Medlam

The characteristic requirements for flight information displays for the Public and for airport staff are essentially different while the actual information is the same. The Public…

108

Abstract

The characteristic requirements for flight information displays for the Public and for airport staff are essentially different while the actual information is the same. The Public search for information about a single flight on a one at a time basis. However, airport staff need to be aware of all pertinent information at all times in order to carry out their jobs.

Details

Aircraft Engineering and Aerospace Technology, vol. 53 no. 12
Type: Research Article
ISSN: 0002-2667

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Article
Publication date: 13 March 2017

Todsaporn Fuangrod, Peter B. Greer, John Simpson, Benjamin J. Zwan and Richard H. Middleton

Due to increasing complexity, modern radiotherapy techniques require comprehensive quality assurance (QA) programmes, that to date generally focus on the pre-treatment stage. The…

287

Abstract

Purpose

Due to increasing complexity, modern radiotherapy techniques require comprehensive quality assurance (QA) programmes, that to date generally focus on the pre-treatment stage. The purpose of this paper is to provide a method for an individual patient treatment QA evaluation and identification of a “quality gap” for continuous quality improvement.

Design/methodology/approach

A statistical process control (SPC) was applied to evaluate treatment delivery using in vivo electronic portal imaging device (EPID) dosimetry. A moving range control chart was constructed to monitor the individual patient treatment performance based on a control limit generated from initial data of 90 intensity-modulated radiotherapy (IMRT) and ten volumetric-modulated arc therapy (VMAT) patient deliveries. A process capability index was used to evaluate the continuing treatment quality based on three quality classes: treatment type-specific, treatment linac-specific, and body site-specific.

Findings

The determined control limits were 62.5 and 70.0 per cent of the χ pass-rate for IMRT and VMAT deliveries, respectively. In total, 14 patients were selected for a pilot study the results of which showed that about 1 per cent of all treatments contained errors relating to unexpected anatomical changes between treatment fractions. Both rectum and pelvis cancer treatments demonstrated process capability indices were less than 1, indicating the potential for quality improvement and hence may benefit from further assessment.

Research limitations/implications

The study relied on the application of in vivo EPID dosimetry for patients treated at the specific centre. Sampling patients for generating the control limits were limited to 100 patients. Whilst the quantitative results are specific to the clinical techniques and equipment used, the described method is generally applicable to IMRT and VMAT treatment QA. Whilst more work is required to determine the level of clinical significance, the authors have demonstrated the capability of the method for both treatment specific QA and continuing quality improvement.

Practical implications

The proposed method is a valuable tool for assessing the accuracy of treatment delivery whilst also improving treatment quality and patient safety.

Originality/value

Assessing in vivo EPID dosimetry with SPC can be used to improve the quality of radiation treatment for cancer patients.

Details

International Journal of Health Care Quality Assurance, vol. 30 no. 2
Type: Research Article
ISSN: 0952-6862

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