When is Better Best? A multiobjective perspective

TL;DR

This paper reviews recent radiation therapy treatment plan comparison studies, highlighting the need for improved standards in study design and reporting to support better decision-making.

Contribution

It introduces a decision theoretical framework to evaluate and improve the informativeness of treatment plan comparison methods.

Findings

Current studies lack correlation analysis between objectives

Statistical comparisons are insufficient for robust decision analysis

Improved standards are needed for designing and reporting studies

Abstract

Purpose: To identify the most informative methods for reporting results of treatment planning comparisons. Methods: Seven papers from the past year of International Journal of Radiation Oncology Biology Physics reported on comparisons of treatment plans for IMRT and IMAT. The papers were reviewed to identify methods of comparisons. Decision theoretical concepts were used to evaluate the study methods and highlight those that provide the most information. Results: None of the studies examined the correlation between objectives. Statistical comparisons provided some information but not enough to make provide support for a robust decision analysis. Conclusion: The increased use of treatment planning studies to evaluate different methods in radiation therapy requires improved standards for designing the studies and reporting the results.