Room: AAPM ePoster Library
Purpose: To measure the diffusion of innovation in radiation oncology in the United States and determine the barriers in utilizing innovation in the clinic.
Methods: In internet based survey was conducted using a custom designed questionnaire. Two hundred and forty medical physicists participated in the study. The dependent variable, innovation score, was measured using 20 unique indicators in five categories: patient positioning, patient treatment, treatment planning, quality assurance, and workflow. Participant answers were entered using a slider with scale 0-100. The innovation utilization score was calculated for each responded, to assess how respondents actually used the innovations available to them. Participants also identified the barriers they face in implementing innovative techniques in the following categories: innovations (lack of evidence, complexity, lack of time/staffing, lack of training and support, lack of interest, lack of interoperability, and lack of reimbursement.
Results: The mean innovation score difference for centers with university affiliation (M = 13.19, SD = 4.76) is higher than the mean innovation score for centers without a university affiliation (M = 11.55, SD = 4.63), a statistically significant difference MD = 1.65, 95% CI[0.38,2.917], t(211) = 2.56, p = 0.011, d = 0.351. Urban centers have a higher innovation scores in patient positioning (MD = 0.31, 95% CI [0.011,0.612], t(203) = 2.043, p = 0.042, d = 0.293) and patient treatment (MD = 0.62, 95% CI [0.23,1.00], t(203) = 3.145, p = 0.002, d = 0.457). Treatment planning has the most statistically significant Spearman correlation barriers (lack of evidence rs = 0.203, p<0.05, complexity rs = 0.175, p<0.05, lack of time and staffing rs = 0.237, p<0.01, lack of inter-operability rs = 0.203, p<0.05, and lack of reimbursement rs = 0.269, p<0.01).
Conclusion: The field as a whole is not practicing as innovative as reasonably achievable.