When is Better Best? A multiobjective perspective
  Purpose: To identify the most informative methods for reporting results of treatment planning comparisons.   Methods: Seven papers from the past year of International Journal of Radiation Oncology Biology Physics reported on comparisons of treatment plans for IMRT and IMAT. The papers were reviewed to identify methods of comparisons. Decision theoretical concepts were used to evaluate the study methods and highlight those that provide the most information.   Results: None of the studies examined the correlation between objectives. Statistical comparisons provided some information but not enough to make provide support for a robust decision analysis.   Conclusion: The increased use of treatment planning studies to evaluate different methods in radiation therapy requires improved standards for designing the studies and reporting the results. 
Mark Phillips and Clay Holdsworth
physics.med-ph