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<h5 class="section-title" id="d10948934e308">Purpose</h5>
<p id="P1">Leaders in the oncology community are sounding a clarion call to promote
“value” in
cancer care decisions. Value in cancer care considers the clinical effectiveness,
along with the costs, when selecting a treatment. To discuss possible solutions to
the current obstacles to achieving value in the use of advanced technologies in oncology,
the National Cancer Policy Forum of the National Academies of Sciences, Engineering,
and Medicine held a workshop, “Appropriate Use of Advanced Technologies for Radiation
Therapy and Surgery in Oncology” in July 2015. The present report summarizes the discussions
related to radiation oncology.
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<h5 class="section-title" id="d10948934e313">Methods and Materials</h5>
<p id="P2">The workshop convened stakeholders, including oncologists, researchers,
payers, policymakers,
and patients. Speakers presented on key themes, including the rationale for a value
discussion on advanced technology use in radiation oncology, the generation of scientific
evidence for value of advanced radiation technologies, the effect of both scientific
evidence and “marketplace” (or economic) factors on the adoption of technologies,
and newer approaches to improving value in the practice of radiation oncology. The
presentations were followed by a panel discussion with dialogue among the stakeholders.
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<h5 class="section-title" id="d10948934e318">Results</h5>
<p id="P3">Challenges to generating evidence for the value of advanced technologies
include obtaining
contemporary, prospective, randomized, and representative comparative effectiveness
data. Proposed solutions include the use of prospective registry data; integrating
radiation oncology treatment, outcomes, and quality benchmark data; and encouraging
insurance coverage with evidence development. Challenges to improving value in practice
include the slow adoption of higher value and the de-adoption of lower value treatments.
The proposed solutions focused on engaging stakeholders in iterative, collaborative,
and evidence-based efforts to define value and promote change in radiation oncology
practice. Recent examples of ongoing or successful responses to the discussed challenges
were provided.
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<h5 class="section-title" id="d10948934e323">Conclusions</h5>
<p id="P4">Discussions of “value” have increased as a priority in the radiation oncology
community.
Practitioners in the radiation oncology community can play a critical role in promoting
a value-oriented framework to approach radiation oncology treatment.
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