Peer pressure.

How often do you “choose wisely?” When it comes to the palliation of bone mets, national organizations favor a single palliative radiation dose when possible. But what does it take to turn recommendations into practice? This study compares the frequency of single fraction palliative radiation for bone metastases before and after mandatory peer review of the dose and fractionation used. The old colleague looking over the shoulder trick was associated with a decrease in the frequency of protracted (>10 fraction) courses from 16 → 6%. At the same time, the frequency of shorter (≤5 fractions) courses went from one-third to nearly one-half of all treatment courses. TBL: Having your treatment decisions displayed in front of peers may better align them with best-practice guidelines. | Walker, J Oncol Pract 2018