ProKnow can be used while further evidence is generated. This includes use of all 3 ProKnow modules:
ProKnow DS – a database used for importing, analysing and storing patient data
ProKnow CA – a contouring accuracy tool to practise, study and improve anatomical contouring
ProKnow PS – a platform for creating and comparing radiotherapy treatment plans.
Potential benefits of early access
Access: In March 2022, NHS England commissioned a pilot of ProKnow (including all 3 modules) across 49 specialist cancer centres with funding provided until March 2025 as part of the Radiotherapy Transformation Programme. The programme aims to improve quality and reduce variability in radiotherapy services across the NHS.
System benefit: Early evidence suggests that ProKnow may help to increase the number of treatment plans that are peer reviewed, either within or between centres. This could reduce variation in practice and improve knowledge sharing between healthcare professionals. This could lead to increased adherence to national guidance and local peer review protocols, and to improvements in the overall quality of radiotherapy treatment plans. ProKnow also offers clinical oncology training tools, which can be used to improve staff training in radiotherapy treatment planning.
Equality: ProKnow enables clinicians to access and peer review radiotherapy treatment plans remotely, so it may particularly benefit smaller centres by providing access to clinical oncologists from other centres and improve care across the UK. ProKnow may also provide greater benefit in cases relating to rare or complex cancers, when there is more need for plans to be peer reviewed.
Considerations for early access
Information governance: Adverse events relating to patient care are not expected when using ProKnow, but potential risks include confidentiality breaches or issues accessing or retrieving data. So, all centres should ensure they have appropriate IT infrastructure and information governance protocols in place.
Outcomes: ProKnow is not expected to directly affect patient outcomes. How much ProKnow improves the quality of radiotherapy contours and treatment plans is likely to be difficult to quantify and attribute costs to. Surrogate outcome measures may be needed to quantify the quality of radiotherapy treatment plans.
Costs: ProKnow may help to increase the number of treatment plans and contours that are peer reviewed and provide a place to document their quality assurance, which may lead to benefits for people having radiotherapy. Increased peer review is likely to increase staff time and costs, which should be considered in addition to the cost of purchasing ProKnow.
Further evidence should be generated on:
the impact on quality assurance for radiotherapy treatment planning, including surrogate, qualitative, and quantitative measures such as:
changes to radiotherapy treatment plans
dose prescription changes
dose volume distributions
scorecards.
healthcare professionals' experience of using ProKnow, including usability
ease of retrieving and storing patient data
radiotherapy treatment planning time (including difference in time to start of treatment)
changes in the number of internal and external peer reviews
the impact on staffing and treatment planning resources
the impact on clinical oncology training for healthcare professionals who contribute to radiotherapy treatment planning
the ability for data linkage to national registries (including change in the number of treatment plans added to national registries)
changes in inequality of access.
Find out more in the evidence generation section of this guidance.
The evidence generation plan gives further information on the prioritised evidence gaps and outcomes, ongoing studies and potential real-world data sources. It includes how the evidence gaps could be resolved through real-world evidence studies.