Impact of High-Dose-Rate Brachytherapy Training via Telehealth in Low- and Middle-Income Countries

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Impact of High-Dose-Rate Brachytherapy Training via Telehealth in Low- and Middle-Income Countries


JournalJCO Global Oncology
Article typeJournal research article – Clinical research
Publication date – Nov – 2020
Authors – Jeremy B. Hatcher, Oluwadamilola Oladeru , Betty Chang, Sameeksha Malhotra, Megan Mcleod , Adam Shulman, Claire Dempsey, Layth Mula-Hussain , Michael Tassoto, Peter Sandwall , Sonja Dieterich, Lina Sulieman, Dante Roa , and Benjamin Li
KeywordsBrachytherapy, Low-and middle-income countries, Telehealth, training
Open access – Yes
SpecialitySurgical Education, Surgical oncology
World region Global

Language – English
Submitted to the One Surgery Index on December 10, 2020 at 5:28 pm
Abstract:

PURPOSE
Our objective was to demonstrate the efficacy of a telehealth training course on high-dose-rate (HDR) brachytherapy for gynecologic cancer treatment for clinicians in low- and middle-income countries (LMICs)

METHODS
A 12-week course consisting of 16 live video sessions was offered to 10 cancer centers in the Middle East, Africa, and Nepal. A total of 46 participants joined the course, and 22 participants, on average, attended each session. Radiation oncologists and medical physicists from 11 US and international institutions prepared and provided lectures for each topic covered in the course. Confidence surveys of 15 practical competencies were administered to participants before and after the course. Competencies focused on HDR commissioning, shielding, treatment planning, radiobiology, and applicators. Pre- and post-program surveys of provider confidence, measured by 5-point Likert scale, were administered and compared.

RESULTS
Forty-six participants, including seven chief medical physicists, 16 senior medical physicists, five radiation oncologists, and three dosimetrists, representing nine countries attended education sessions. Reported confidence scores, both aggregate and paired, demonstrated increases in confidence in all 15 competencies. Post-curriculum score improvement was statistically significant (P < .05) for paired respondents in 11 of 15 domains. Absolute improvements were largest for confidence in applicator commissioning (2.3 to 3.8, P = .009), treatment planning system commissioning (2.2 to 3.9, P = .0055), and commissioning an HDR machine (2.2 to 4.0, P = .0031). Overall confidence in providing HDR brachytherapy services safely and teaching other providers increased from 3.1 to 3.8 and 3.0 to 3.5, respectively.

CONCLUSION
A 12-week, low-cost telehealth training program on HDR brachytherapy improved confidence in treatment delivery and teaching for clinicians in 10 participating LMICs.

OSI Number – 20789
PMID – 33216647

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