Overt Scientific Bias and Clandestine Acts by Trusted Scientists: The Flawed Application of the Linear No-threshold Model.

ABSTRACT: The Health Physics Society (HPS) released a video documentary on the history of the linear no-threshold (LNT) model in April 2022. It exposed many scientific and ethical failings of many leaders, influential scientists, and organizations that have resulted in the current system of radiological protection. Since then, the society received many comments; most were supportive, while a few criticized the video documentary as delivering an anti-LNT message. Shortly thereafter, many emails discovered via an independent Freedom of Information Act request revealed multiple layers of coordination between prominent people in the field of radiation protection to coopt the leadership within the HPS and suppress information they perceived or assumed to be contrary to a pro-LNT message. Many of these emails were published by JunkScience.com, an independent organization that exposes faulty scientific data and analyses used to advance special interests and hidden agendas. This Forum article is intended to document in the peer-reviewed literature the JunkScience.com findings of clandestine acts by trusted scientists within the radiation protection community. The emails exposed strong personal biases, actions taken by leaders within the National Commission on Radiation Protection and Measurements (NCRP) to "save the Society" from its "downward spiral," and actions taken by NCRP and HPS members serving on a National Academies of Sciences committee to suppress scientific information relevant to the debate about health effects in low-dose environments. These anti-science actions harm our entire profession and the trust that Congress bestows on our scientific organizations expecting to receive objective recommendations based on sound science. It is important that these events are recorded in the scientific literature from a historical perspective. The radiation protection community will be judged not by what is revealed in this article but by what actions are taken from here.

Professional ethics in the French medical physicist community: Survey results and implications.

INTRODUCTION: Since 2017, in France, medical physicists (MP) are finally defined by law as health professionals and as such, the roles and responsibilities of an MP lean on those medical professional ethics but MPs lack initial or continuing training in this subject. In order to find out how our colleagues feel about this subject, the following survey was conducted. METHODS: French Society of Medical Physics (SFPM) designed a web survey addressed to its members and non-members concerning ethics based on the 2013 AAPM work; experience and training were highlighted as particularly important within the survey structure. RESULTS: 249 answers were collected and showed a pronounced concern at the lack of initial and continuous training in this subject. Professional experience of non-ethical behaviour was attributed to the lack of training, resources or competences and hostile work environments. CONCLUSION: To address the shortcomings highlighted in the survey, SFPM has created a dedicated voluntary working group aimed at producing a professional code of ethics for MP and training modules to be applied at entry level or as continuing professional development for education.

Has Health Physics Contributed to an 80-y False Narrative about the Trinity Nuclear Test?

ABSTRACT: This paper discusses the various analyses of the Trinity Nuclear Test, including how they might apply to the issue of infant mortality. This paper was first drafted as a response to a letter by Rice, who commented on my earlier letter on that issue. My earlier letter commented on the National Cancer Institute's 2020 series of papers in the October Issue of Health Physics on the impact of the Trinity Nuclear Test that was conducted on unoccupied government lands on 16 July 1945. The Journal editors requested that my response to Rice be edited and submitted as a paper to ensure adequate technical review and suggested that the article also add material summarizing the series of exchanges that were published in the Journal. This article suggests that significant differences exist between various summaries of the offsite impact of the Trinity Nuclear Test and offers that Trinity might be the largest nuclear accident in terms of the impact on uninvolved civilians who were downwind following the test. It suggests areas for further study to resolve these significant differences. It also asserts that until the estimated exposures of downwind residents are resolved and an appropriate study is made of infant deaths following the Trinity Nuclear Test, the issue of infant mortality remains an unanswered, 80-y-old question.

Demographics of the members of the special interest group for early career medical physicists: A statistical analysis of survey results.

INTRODUCTION: The Early Career Medical Physicists Special Interest Group (SIG_FREC) that operates within EFOMP aims to represent individuals with less than 10 years of experience working as medical physics professionals. The purpose of this survey was to better understand the specific needs and expectations of early-career medical physicists across Europe. The aim of this study was to allow these early-career professionals to voice their ideas within EFOMP and provide insights into their challenges and opportunities while also providing them with the possibility of making suggestions for the growth of the SIG. Doing this, the members can be better equipped to be future leaders of the Medical Physics profession in their own country and in Europe. METHODS: The Steering Committee of SIG_FREC developed a questionnaire and distributed it to its members. RESULTS: Out of the total number of members of the SIG_FREC at the time of the questionnaire (97 members), 42 of them responded to the survey yielding a response rate of 43%. These provided valuable insights based on their experiences about medical physics in their country. CONCLUSION: The responses to the questionnaire provided a snapshot of the opinion of early-career medical physicists, representing a wide geographical distribution across Europe. The feedback from SIG_FREC members highlighted potential future operations within EFOMP.

Dosimetric Validation of Treatment Planning System for Volumetric Modulated Arc Therapy Using AAPM Medical Physics Practice Guideline 5.b.

AIM: To assess the precision of dose calculations for Volumetric Modulated Arc Therapy (VMAT) using megavoltage (MV) photon beams, we validated the accuracy of two algorithms: AUROS XB and Analytical Anisotropic Algorithm (AAA). This validation will encompass both flattening filter (FF) and flattening filter-free beam (FFF) modes, using AAPM Medical Physics Practice Guideline (MPPG 5b). MATERIALS AND METHODS: VMAT validation tests were generated for 6 MV FF and 6 MV FFF beams using the AAA and AXB algorithms in the Eclipse V.15.1 treatment planning system (TPS). Corresponding measurements were performed on a linear accelerator using a diode detector and a radiation field analyzer. Point dose (PD) and in-vivo measurements were conducted using an A1SL ion chamber and (TLD) from Thermofisher, respectively. The Rando Phantom was employed for end-to-end (E2E) tests. RESULTS: The mean difference (MD) between the TPS-calculated values and the measured values for the PDD and output factors were within 1% and 0.5%, respectively, for both 6 MV FF and 6 MV FFF. In the TG 119 sets, the MD for PD with both AAA and AXB was <0.9%. For the TG 244 sets, the minimum, maximum, and mean deviations in PD for both 6 MV FF and 6 MV FFF beams were 0.3%, 1.4% and 0.8% respectively. In the E2E test, using the Rando Phantom, the MD between the TLD dose and the TPS dose was within 0.08% for both 6 MV FF (p=1.0) and 6 MV FFF (0.018) beams. CONCLUSION: The accuracy of the TPS and its algorithms (AAA and AXB) has been successfully validated. The recommended tests included in the VMAT/IMRT validation section proved invaluable for verifying the PDD, output factors, and the feasibility of complex clinical cases. E2E tests were instrumental in validating the entire workflow from CT simulation to treatment delivery.

Implementation of a programmatic assessment model in radiation oncology medical physics training.

PURPOSE: In 2019, a formal review and update of the current training program for medical physics residents/registrars in Australasia was conducted. The purpose of this was to ensure the program met current local clinical and technological requirements, to improve standardization of training across Australia and New Zealand and generate a dynamic curriculum and programmatic assessment model. METHODS: A four-phase project was initiated, including a consultant desktop review of the current program and stakeholder consultation. Overarching program outcomes on which to base the training model were developed, with content experts used to update the scientific content. Finally, assessment specialists reviewed a range of assessment models to determine appropriate assessment methods for each learning outcome, creating a model of programmatic assessment. RESULTS: The first phase identified a need for increased standardized assessment incorporating programmatic assessment. Seven clear program outcome statements were generated and used to guide and underpin the new curriculum framework. The curriculum was expanded from the previous version to include emerging technologies, while removing previous duplication. Finally, a range of proposed assessments for learning outcomes in the curriculum were generated into the programmatic assessment model. These new assessment methods were structured to incorporate rubric scoring to provide meaningful feedback. CONCLUSIONS: An updated training program for Radiation Oncology Medial Physics registrars/residents was released in Australasia. Scientific content from a previous program was used as a foundation and revised for currency with the ability to accommodate a dynamic curriculum model. A programmatic model of assessment was created after comprehensive review and consultation. This new model of assessment provides more structured, ongoing assessment throughout the training period. It contains allowances for local bespoke assessment, and guidance for supervisors by the provision of marking templates and rubrics.

Clinical physicists' perceptions of weekly chart checks and the potential role for automated image review assessed by structured interviews.

BACKGROUND: This study utilizes interviews of clinical medical physicists to investigate self-reported shortcomings of the current weekly chart check workflow and opportunities for improvement. METHODS: Nineteen medical physicists were recruited for a 30-minute semi-structured interview, with a particular focus placed on image review and the use of automated tools for image review in weekly checks. Survey-type questions were used to gather quantitative information about chart check practices and importance placed on reducing chart check workloads versus increasing chart check effectiveness. Open-ended questions were used to probe respondents about their current weekly chart check workflow, opinions of the value of weekly chart checks and perceived shortcomings, and barriers and facilitators to the implementation of automated chart check tools. Thematic analysis was used to develop common themes across the interviews. RESULTS: Physicists ranked highly the value of reducing the time spent on weekly chart checks (average 6.3 on a scale from 1 to 10), but placed more value on increasing the effectiveness of checks with an average of 9.2 on a 1-10 scale. Four major themes were identified: (1) weekly chart checks need to adapt to an electronic record-and-verify chart environment, (2) physicists could add value to patient care by analyzing images without duplicating the work done by physicians, (3) greater support for trending analysis is needed in weekly checks, and (4) automation has the potential to increase the value of physics checks. CONCLUSION: This study identified several key shortcomings of the current weekly chart check process from the perspective of the clinical medical physicist. Our results show strong support for automating components of the weekly check workflow in order to allow for more effective checks that emphasize follow-up, trending, failure modes and effects analysis, and allow time to be spent on other higher value tasks that improve patient safety.

AAPM WGPE report 394: Simulated error training for the physics plan and chart review.

BACKGROUND: Simulated error training is a method to practice error detection in situations where the occurrence of error is low. Such is the case for the physics plan and chart review where a physicist may check several plans before encountering a significant problem. By simulating potentially hazardous errors, physicists can become familiar with how they manifest and learn from mistakes made during a simulated plan review. PURPOSE: The purpose of this project was to develop a series of training datasets that allows medical physicists and trainees to practice plan and chart reviews in a way that is familiar and accessible, and to provide exposure to the various failure modes (FMs) encountered in clinical scenarios. METHODS: A series of training datasets have been developed that include a variety of embedded errors based on the risk-assessment performed by American Association of Physicists in Medicine (AAPM) Task Group 275 for the physics plan and chart review. The training datasets comprise documentation, screen shots, and digital content derived from common treatment planning and radiation oncology information systems and are available via the Cloud-based platform ProKnow. RESULTS: Overall, 20 datasets have been created incorporating various software systems (Mosaiq, ARIA, Eclipse, RayStation, Pinnacle) and delivery techniques. A total of 110 errors representing 50 different FMs were embedded with the 20 datasets. The project was piloted at the 2021 AAPM Annual Meeting in a workshop where participants had the opportunity to review cases and answer survey questions related to errors they detected and their perception of the project's efficacy. In general, attendees detected higher-priority FMs at a higher rate, though no correlation was found between detection rate and the detectability of the FMs. Familiarity with a given system appeared to play a role in detecting errors, specifically when related to missing information at different locations within a given software system. Overall, 96% of respondents either agreed or strongly agreed that the ProKnow portal and training datasets were effective as a training tool, and 75% of respondents agreed or strongly agreed that they planned to use the tool at their local institution. CONCLUSIONS: The datasets and digital platform provide a standardized and accessible tool for training, performance assessment, and continuing education regarding the physics plan and chart review. Work is ongoing to expand the project to include more modalities, radiation oncology treatment planning and information systems, and FMs based on emerging techniques such as auto-contouring and auto-planning.

Technical note: A universal worksheet for failure mode and effects analysis-A project of the Japanese College of Medical Physics.

BACKGROUND: Failure mode and effects analysis (FMEA), which is an effective tool for error prevention, has garnered considerable attention in radiotherapy. FMEA can be performed individually, by a group or committee, and online. PURPOSE: To meet the needs of FMEA for various purposes and improve its accessibility, we developed a simple, self-contained, and versatile web-based FMEA risk analysis worksheet. METHODS: We developed an FMEA worksheet using Google products, such as Google Sheets, Google Forms, and Google Apps Script. The main sheet was created in Google Sheets and contained elements necessary for performing FMEA by a single person. Automated tasks were implemented using Apps Script to facilitate multiperson FMEA; these functions were built into buttons located on the main sheet. RESULTS: The usability of the FMEA worksheet was tested in several situations. The worksheet was feasible for individual, multiperson, seminar, meeting, and online purposes. Simultaneous online editing, automated survey form creation, automatic analysis, and the ability to respond to the form from multiple devices, including mobile phones, were particularly useful for online and multiperson FMEA. Automation enabled through Google Apps Script reduced the FMEA workload. CONCLUSIONS: The FMEA worksheet is versatile and has a seamless workflow that promotes collaborative work for safety.

A Perspective from Ontario Tech University Industrial Research Chairs on 20 Years of Capacity Building in Health Physics and Radiation Science.

ABSTRACT: Ontario Tech University (University of Ontario Institute of Technology) is one of Canada's newest universities, having been incorporated in 2002. In 20 y, the University has increased enrollment from a few hundred students to over 10,000. The University was designed to be "market driven" and as such offered courses that had high market demand. The Faculty of Energy Systems and Nuclear Science was one of the first faculties to be established at the University, with the intent to fill a gap between personnel that were retiring out of the nuclear industry and the dearth of nuclear engineers and health physicists being educated in Canada. As such, the University established unique programs in both nuclear engineering and health physics/radiation science with strong input from industry stakeholders. This paper will discuss the evolution of the Health Physics and Radiation Science program at Ontario Tech from the teaching and capacity building perspective, and it provides insight regarding health physics and radiation science research at Ontario Tech under the industrial research chair program.