Applying a New CT Quality Metric in Radiology: How CT Pulmonary Angiography Repeat Rates Compare Across Institutions.

Autor:	Rose S; Department of Medical Physics, University of Wisconsin Madison, Madison, Wisconsin., Viggiano B; Department of Radiology, University of Wisconsin Madison, Madison, Wisconsin., Bour R; Department of Radiology, University of Wisconsin Madison, Madison, Wisconsin., Bartels C; Department of Radiology, University of Wisconsin Madison, Madison, Wisconsin., Kanne JP; Vice Chair of Quality and Safety, Department of Radiology, University of Wisconsin, Madison, Wisconsin., Szczykutowicz TP; Department of Medical Physics, University of Wisconsin Madison, Madison, Wisconsin; Department of Radiology, University of Wisconsin Madison, Madison, Wisconsin; Department of Biomedical Engineering, University of Wisconsin Madison, Madison, Wisconsin. Electronic address: tszczykutowicz@uwhealth.org.
Jazyk:	angličtina
Zdroj:	Journal of the American College of Radiology : JACR [J Am Coll Radiol] 2021 Jul; Vol. 18 (7), pp. 962-968. Date of Electronic Publication: 2021 Mar 16.
DOI:	10.1016/j.jacr.2021.02.014
Abstrakt:	Objectives: To quantify overall CT repeat and reject rates at five institutions and investigate repeat and reject rates for CT pulmonary angiography (CTPA). Methods: In this retrospective study, we apply an automated repeat rate analysis algorithm to 103,752 patient examinations performed at five institutions from July 2017 to August 2019. The algorithm identifies repeated scans for specific scanner and protocol combinations. For each institution, we compared repeat rates for CTPA to all other CT protocols. We used logistic regression and analysis of deviance to compare CTPA repeat rates across institutions and size-based protocols. Results: Of 103,752 examinations, 1,447 contained repeated helical scans (1.4%). Overall repeat rates differed across institutions (P < .001) ranging from 0.8% to 1.8%. Large-patient CTPA repeat rates ranged from 3.0% to 11.2% with the odds (95% confidence intervals) of a repeat being 4.8 (3.5-6.6) times higher for large- relative to medium-patient CTPA protocols. CTPA repeat rates were elevated relative to all other CT protocols at four of five institutions, with strong evidence of an effect at two institutions (P < .001 for each; odds ratios: 2.0 [1.6-2.6] and 6.2 [4.4-8.9]) and somewhat weaker evidence at the others (P = .005 and P = 0.011; odds ratios: 2.2 [1.3-3.8] and 3.7 [1.5-9.1], respectively). Accounting for size-based protocols, CTPA repeat rates differed across institutions (P < .001). Discussion: The results indicate low overall repeat rates (<2%) with CTPA rates elevated relative to other protocols. Large-patient CTPA rates were highest (eg, 11.2% at one institution). Differences in repeat rates across institutions suggest the potential for quality improvement. (Copyright © 2021 American College of Radiology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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