Quality Assurance (QA) measures are a standard part of radiation therapy. But given that these measures are often carried out in combination with one another, it's difficult, if not impossible, to know which are actually effective.
A team of researchers from Johns Hopkins, working in collaboration with a group from Washington University in St. Louis, set out to understand the impact of commonly used QA measures including physician plan review, physics chart checks, port films and checklists. They found significant variation in the effectiveness of individual measures. Moreover, no single QA check was able to detect patient safety errors 100% of the time.
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My colleague Nicholas Bartz from the Imaging Performance Partnership recently wrote a nice summary and analysis of the results from the NCI's National Lung Screening Trial, and I wanted to pass it along:
In October 2010 the National Cancer Institute announced a premature end to its National Lung Screening Trial after finding that low-dose CT screening of high-risk participants was associated with a 20 percent mortality reduction. Now, as the first formal report of that trial appears in the New England Journal of Medicine, both the trial's researchers and outside parties are raising questions as to whether CT lung screening is ready to be implemented on a broad scale.
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Dendreon, the maker of the Provenge, the expensive new cancer vaccine, has seen it's stock price plummet the past few days admist reports that sales of Provenge have not been hitting targets. There is a lot of speculation as to what is limiting sales - is it the high cost? Difficulty accessing the therapy (as it is not simply a pill) etc? According to Dendreon executives, the problem lies with physicians - because they adminster the drug in their offices, they are on the hook if the payment is denied. As such, they want more familiarity with the reimbursement environment before they beginning using it more broadly.
Given ongoing concerns around the cost of cancer care, this is an interesting development and may indicate that payers' - both CMS and commerical - strategy to hold the line on ensuring proper utilization as a means to control costs may be working. It's early days yet, so we'll have to keep tabs on this story and see if sales begin to pick up in line with what was initially forecast when Provenge was approved.