Publications by authors named "Covington E"

Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT), collectively termed SRS-SBRT, are advanced treatment modalities delivering high doses of radiation in a single treatment or condensed treatment phase. Due to the small margins and steep dose gradient used in SRS-SBRT, the technical and safety considerations are more stringent than traditional radiation therapy and may include more advanced simulation, patient immobilization, treatment planning, and treatment delivery techniques. Respiratory motion management and intrafraction motion monitoring are often used during SRS-SBRT to ensure treatments are robust to both internal organ motion and patient movement during treatment.

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Purpose/objectives: Tracking patient dose in radiation oncology is challenging due to disparate electronic systems from various vendors. Treatment planning systems (TPS), radiation oncology information systems (ROIS), and electronic health records (EHR) lack uniformity, complicating dose tracking and reporting. To address this, we examined practices in multiple radiation oncology settings and proposed guidelines for current systems.

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Article Synopsis
  • * Only 41.8% of GPT-3.5 responses were deemed useful by SMEs, with median ratings indicating responses were mostly correct and safe, but often incomplete.
  • * The agreement among experts on response ratings showed fair to substantial reliability, but overall, GPT-3.5's responses are not a substitute for those from an ID pharmacist.
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Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

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The increasing complexity of radiation therapy treatment presents new potentials for error and suboptimal care. High-performing programs thus not only require adherence to, but also ongoing improvement of, key safety and quality practices. In this article, we review these practices including standardization, risk analysis, peer review, and maintenance of strong safety culture, while also describing recent innovations and promising future directions.

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Article Synopsis
  • New technologies in radiation oncology can create health care disparities, particularly affecting vulnerable patient populations, necessitating the assessment of these disparities for both existing and new technologies.* -
  • A health disparity risk assessment metric was developed, allowing clinics to determine the potential disparities among patient populations and providing guidelines for addressing these disparities in technology use.* -
  • This metric calculates a disparity risk priority number based on patient impact, the quality of radiation plans, and clinical reliance on technology, enabling clinics to prioritize interventions to enhance equitable care.*
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Background: ChatGPT is a conversational artificial intelligence technology that has shown application in various facets of healthcare. With the increased use of AI, it is imperative to assess the accuracy and comprehensibility of AI platforms.

Objective: This pilot project aimed to assess the understandability, readability, and accuracy of ChatGPT as a source of medication-related patient education as compared with an evidence-based medicine tertiary reference resource, LexiComp®.

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Purpose: AAPM Task Group No. 263U1 (Update to Report No. 263 - Standardizing Nomenclatures in Radiation Oncology) disseminated a survey to receive feedback on utilization, gaps, and means to facilitate further adoption.

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Although standardization has been shown to improve patient safety and improve the efficiency of workflows, implementation of standards can take considerable effort and requires the engagement of all clinical stakeholders. Engaging team members includes increasing awareness of the proposed benefit of the standard, a clear implementation plan, monitoring for improvements, and open communication to support successful implementation. The benefits of standardization often focus on large institutions to improve research endeavors, yet all clinics can benefit from standardization to increase quality and implement more efficient or automated workflow.

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Keeping abreast of the antimicrobial stewardship-related articles published each year is challenging. The Southeastern Research Group Endeavor identified antimicrobial stewardship-related, peer-reviewed literature that detailed an actionable intervention during 2022. The top 13 publications were selected using a modified Delphi technique.

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Purpose: Women remain underrepresented in medical physics in the United States, and determinants of persisting disparities remain unclear. Here, we performed a detailed investigation of American Association of Physicists in Medicine (AAPM) membership trajectories to evaluate trends in Full membership with respect to gender, age, and highest degree.

Methods And Materials: Membership data, including gender, date of birth, highest degree, membership type, and years of active membership for 1993 to 2023 were obtained from AAPM.

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Article Synopsis
  • This study focused on the incidence and treatment outcomes of disseminated Bartonella spp. infections, which are typically diagnosed using molecular tests like PCR due to limitations in traditional culture methods.
  • The research analyzed data from patients diagnosed with bartonellosis between 2014 and 2021, primarily identifying Bartonella henselae as the responsible pathogen, with doxycycline and rifampin being the most common treatment.
  • Results showed a notable 39% treatment failure rate, highlighting the importance of using various diagnostic tests and understanding treatment options for managing these infections.
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Background: Vitamin D deficiency is a common finding in critically ill children. However, the optimal supplementation strategy in this patient population is unknown. The objective of this study was to evaluate the effects of high-dose (10 000 IU/kg, max.

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Purpose: Consistency of nomenclature within radiation oncology is increasingly important as big data efforts and data sharing become more feasible. Automation of radiation oncology workflows depends on standardized contour nomenclature that enables toxicity and outcomes research, while also reducing medical errors and facilitating quality improvement activities. Recommendations for standardized nomenclature have been published in the American Association of Physicists in Medicine (AAPM) report from Task Group 263 (TG-263).

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Purpose: With the clinical implementation of kV-CBCT-based daily online-adaptive radiotherapy, the ability to monitor, quantify, and correct patient movement during adaptive sessions is paramount. With sessions lasting between 20-45 min, the ability to detect and correct for small movements without restarting the entire session is critical to the adaptive workflow and dosimetric outcome. The purpose of this study was to quantify and evaluate the correlation of observed patient movement with machine logs and a surface imaging (SI) system during adaptive radiation therapy.

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Background: Vancomycin Bayesian modeling provides 24-hour area under the curve (AUC24) estimations. However, the agreement between two-concentration and one-concentration Bayesian estimates in patients with obesity is unknown.

Objective: The purpose of this study was to determine the agreement between two-concentration and one-concentration Bayesian AUC24 estimates in patients with obesity receiving vancomycin.

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Two methods of area under the curve (AUC) dosing are recommended in vancomycin consensus guidelines: first-order calculations utilizing 2 vancomycin concentrations or a Bayesian approach. It is unknown if there is a difference in acute kidney injury (AKI) between the 2 dosing strategies for patients receiving concomitant piperacillin-tazobactam and vancomycin (VPT). The objective of this study was to compare incidence of AKI in patients being administered VPT with first-order calculations versus model-informed precision dosing (MIPD)/Bayesian dosing.

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Purpose: To commission and assess the clinical performance of a new commercial surface imaging (SI) system by analyzing intra-fraction motion from the initial cohort of patients treated with frameless stereotactic radiosurgery (fSRS).

Methods: The IDENTIFY SI system was commissioned for clinical use on an Edge (Varian Medical Systems, Palo Alto, CA) linear accelerator. All patients who received intracranial radiotherapy with HyperArc (Varian Medical Systems, Palo Alto, CA) were immobilized with the Encompass (Qfix, Avondale, PA) thermoplastic mask and monitored for intra-fraction motion with SI.

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Purpose: The ongoing lack of data standardization severely undermines the potential for automated learning from the vast amount of information routinely archived in electronic health records (EHRs), radiation oncology information systems, treatment planning systems, and other cancer care and outcomes databases. We sought to create a standardized ontology for clinical data, social determinants of health, and other radiation oncology concepts and interrelationships.

Methods And Materials: The American Association of Physicists in Medicine's Big Data Science Committee was initiated in July 2019 to explore common ground from the stakeholders' collective experience of issues that typically compromise the formation of large inter- and intra-institutional databases from EHRs.

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Keeping abreast of the antimicrobial stewardship-related articles published each year is challenging. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship-related, peer-reviewed literature that detailed an "actionable" intervention among hospitalized populations during 2021. The top 13 publications were selected using a modified Delphi technique.

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Social workers are key members of integrated care (IC) teams, yet there is limited research on the presence and roles of social workers on IC teams. Research literature from 2014 to 2021 was identified using the following search engines: Academic Search Complete, PsycINFO, CINAHL Plus, SocINDEX and MEDLINE. An exploratory search was conducted in January 2021 and an updated search was conducted in August 2021.

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Purpose: Gender-based discrimination and sexual harassment have been well-studied in the fields of science, technology, engineering, math, and medicine. However, less is known about these topics and their effect within the profession of medical physics. We aimed to better understand and clarify the views and experiences of practicing medical physicists and medical physics residents regarding gender-based discrimination and sexual harassment.

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