The primary purpose is to continue and advance the review program developed and implemented by the Quality Assurance Review Center (QARC). Well over 2000 patients per year can be expeditiously and effectively monitored on over 40 protocols at any one time by the current staff at the QARC with the equipment available and with the improved data base management system that is being implemented. Electronic communication may make possible the management of an even larger number of cases and a more effective review process may emerge. Since QARC was established in 1980 to perform quality assurance for radiotherapy components in cooperative group trials, over 8000 patients on 78 protocols in 6 cooperative groups have been processed. Data submission and the appropriateness of the treatment both improves substantially in all groups monitored by QARC. The QARC has also been involved in protocol development to assist in making protocols as umambiguous as possible. The QARC staff has developed educational workshops for each of the groups to enhance the protocol participation. it is our purpose to continue to serve the cooperative groups and to explore improved methods of data handling for the most effective and efficient data management by transferring our data base management to a VAX 750. A pilot study of electronic communication is being developed which will allow the participating institution to be linked by a """"""""star"""""""" network to the QARC computer. This will allow us to expedite routine communications, protocol development, data requests and data acquisition including digital data, graphics and radiological images. The large data base which QARC has accumulated over the last 5 years can be used to develop mathematical models of changes in protocol participation which can describe protocol performance and learning time as functions of protocol complexity, type of institution participating in the protocol and the experience of the radiotherapist. These mathematical models may be used to selectively modify the review process and for educational programs targeted differentially to different classes of protocols, institutions or participants.
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