Physician Experience and Peer Review Change Rates In a Prospective, Disease Site-Specific Quality Assurance Program
Abstract
Purpose
Peer review is a core component of quality assurance in radiation oncology. This study evaluated whether physician years of clinical experience were associated with differences in peer review change rates within a standardized, prospective, disease-site–specific peer review program.
Methods
We conducted a retrospective analysis of all consecutive radiation therapy cases prospectively reviewed at disease-site–specific departmental peer review conferences between June 2024 and January 2026. Peer review was conducted in dedicated 30-minute sessions held 3 to 5 days per week, depending on disease site, using standardized review criteria. Physician-level error rates were calculated as the proportion of reviewed cases with identified recommendations or required modifications. Differences in error rates across experience groups were assessed using the Kruskal–Wallis test. Statistical significance was defined as p < 0.05.
Results
The cohort included 1,638 contour reviews: gastrointestinal (n = 170), genitourinary (n = 846), thoracic (n = 429), and head and neck (n = 193). Thirty eligible attending physicians were categorized by years of clinical experience: 0 to 2 years, 2 to 5 years, and greater than 5 years. Median peer review error rates were 22.6% among physicians with 0 to 2 years of experience (n = 4), 22.9% among those with 2 to 5 years (n = 7), and 25.0% among those with greater than 5 years (n = 19). No significant differences in error rates were observed across experience groups (Kruskal–Wallis H = 1.59, p = 0.45).
Conclusion
Within a standardized, high-frequency, disease-site–specific peer review framework, physician experience was not significantly associated with peer review error rates. These findings suggest peer review provides measurable quality assurance benefits across all experience levels. Structured, system-based prospective peer review may serve as a valuable tool for promoting consistent and sustainable treatment quality throughout clinical practice.