Quality Assurance Review Center
The Quality Assurance Review Center (QARC) is a research program within the
University of Massachusetts Medical School(UMMS) that provides radiotherapy(RT) quality assurance(QA), diagnostic imaging data management, and clinical research support. [http://www.qarc.org/ Quality Assurance Review Center] Located in the Federal Hill neighborhood of Providence, Rhode Island, QARC is a nationally and internationally recognized program serving the National Cancer Institute(NCI) sponsored cooperative groups and industry partners. [http://www.qarc.org/ Quality Assurance Review Center] These cooperative groups and their industry partners conduct a wide variety of clinical trialsin order to evaluate the overall effectiveness of protocol-driven cancertreatment strategies. [http://www.qarc.org/ Quality Assurance Review Center]
History and Mission of QARC
The history of QARC can be traced back to the late 1970s when
Rhode Island Hospitalwas conducting RT QA reviews of leukemia-based protocols for the CALGB, which is one of the major NCI sponsored cooperative groups. Due to the quality managementof the CALGB's trials, other cooperative groups like the Pediatric Oncology Group(POG) and the Children's Cancer Study Group(CCG) decided to ensure the quality of their respective trials through the auspices of QARC. It was at this time that QARC began to seek funding from the NCI in order to manage the large influx of RT data. By 1980, QARC had received its first grant monies from the NCI, as it expanded to cover a wider array of protocol-based studies. [http://www.qarc.org/ Quality Assurance Review Center] Over the course of the next fifteen years of so, QARC began to implement a series of changes to the retrospective review process, especially with regard to its Physics/ Dosimetrydivision. In 1996, QARC switched its affiliation from the Brown University School of Medicine to the UMass Medical School. And in 2003, QARC moved from its former location at the Roger Williams Medical Center(RWMC) to its current site in Federal Hill.
The QARC mission is to improve the standard of care in the management of cancer by ensuring quality. [http://www.qarc.org/ Quality Assurance Review Center] QARC sees that providing quality assurance is essential for ensuring the validity of data across multi-institution and multi-disciplinary cooperative group trials. It employs a methodology that is responsive and supportive of the National Cancer Clinical Trials Enterprise. As radiotherapy evolves in the area of image-based target volume definitions and as digital information continues to supplant hard-copy formats for both diagnostic imaging and RT data, QARC's processes will continually evolve to support these developments. Given today's advanced technologies in the fields of motion management and other real time delivery modifications, QARC strives to meet the growing need for quality in the fast-paced healthcare industry of cancer treatment.
Infrastructure of QARC
The QARC infrastructure is composed of five divisions. These divisions include Administration, Clinical,
Data Management(DM), Information Systems(IS), and Physics/ Dosimetry.
The Administration division is predominantly focused on constructing and sustaining working relationships between QARC and the various NCI supported oncology groups as well as the
pharmaceuticalindustry. It collaborates with the UMass Medical School in matters pertaining to accounting, employment, and professional development. One previous clinical trial that was organized by the division involved French drugmaker Sanofi-Aventisand the experimental chemotherapeuticagent tirapazamine. [http://www.qarc.org/ Quality Assurance Review Center] Most of the major NCI sponsored cooperative groups, which mandate that radiotherapy materials for their respective protocols be sent to QARC for review, include ACOSOG, COG, ECOG, SWOG, and CALGB. [http://www.qarc.org/ Quality Assurance Review Center]
The Clinical division primarily consists of various diagnostic and therapeutic radiologists who conduct both real time and retrospective reviews. In the five years since 2003, QARC has performed interventional RT reviews for over 6,000 protocol-enrolled patients.
The Data Management division receives and processes all forms of data relating to a particular patient and the corresponding protocol. Typical forms of data include diagnostic imaging, physics benchmarks, and
radiologyreports. The diagnostic imaging segment of data management usually involves computed tomography(CT), positron emission tomography(PET), and magnetic resonance imaging(MRI) scans. Occasionally, QARC will obtain gallium and bone scans insofar as a protocol mandates them. With the shift toward nuclear medicinein radiology, QARC seeks to build and maintain a vast database with its data management division.
The Information Systems division maintains and upgrades QARC's digital database. As of 2008, the QARC database contained records on over 40,000 patients enrolled on more than 200 protocols. The RT information and diagnostic imaging data stored on QARC's servers is submitted from around 1,000 hospitals in both the
United Statesand abroad.
The Physics/Dosimetry division is mostly concerned with evaluating the radiation
dosecalculations submitted with each patient on a protocol. In addition, the division works closely with various institutions, which include the cooperative oncologygroups and the pharmaceutical industry partners, to develop and implement new benchmarks for specific areas of radiation therapy. In keeping with its responsibility as a quality assurance agent, the division participates in initial, interventional, and final reviews so as to assure a high degree of integrity with regard to protocol guidelines.
ervices of QARC
*Case Management & Archiving
Radiology& Radiation TherapyCase Review
*Institutional Performance Evaluation & Reporting
*Research & Publications
* [http://www.qarc.org/ Quality Assurance Review Center]
* [http://www.cancer.gov/ National Cancer Institute]
* [http://www.nih.gov/ National Institutes of Health]
* [http://www.umassmed.edu/ UMass Medical School]
* [https://cabig.nci.nih.gov/ caBIG]
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