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PubMed1978

Detection accuracy in chest radiography.

The detection accuracy of the diagnostic radiologist is important in everyday medical decision making. However, little work has been done relating the detection accuracy of the radiologist to the quality of the image. This study, using a thorax and lung phantom, simulated tissue-equivalent 6.4 mm lesions, and a 183 cm source-to-image distance, shows that the detection accuracy is not dependent on the focal spot size (over a range of 0.3-2.0 mm). However, the false positive rate increases when using small focal spots. In addition, the detection accuracy decreases with increasing root-mean-square (RMS) noise (a measure of the amount of quantum mottle in the image), while the false positive rate and intraobserver disagreement increase with increasing RMS noise. It is also shown that the nonradiologist responds to changes in noise in exactly the same way as the radiologist.

Diagnostic Errors↗
PubMed1981

Turf battles.

Explore the source record for details and available documents.

Accreditation↗
PubMed1995

Evaluating health services: the importance of patients' preferences and quality of life.

With limited resources available, we all would like to allocate health care dollars to do the most good. Clinical research tells us what outcomes to expect (in many cases) from the introduction of a health care program, a test, or a therapy. Even primitive cost analysis can assess the cost of such programs. The ability to place a value on health states is vital when assessing how patient outcomes influence the relative cost-effectiveness of medical procedures, therapies, and programs. Without a means to measure the value of a particular health state, one is left to compare apples with oranges and oranges with vacuum cleaners. In fact, comparisons of fruit and home appliances is relatively easy, because one can readily apply monetary values to apples, oranges, and vacuum cleaners and compare dollar amounts. How can one do the same for the outcomes of medical procedures and diagnostic tests? This is the challenge for health services and outcomes researchers throughout the world and, more urgently, the focus of policy makers, governments, and health insurers. The purpose of this paper is to describe quality-adjusted life-years (QALYs), a method that has successfully measured the outcomes of disparate health programs. We will introduce the QALY method, summarize the various methods of measuring and classifying health states, describe three methods that have been used to measure patients' preferences (utilities) for health states, and discuss the limitations of utility assessment and some controversies that result from the measurement and use of utilities and concerning health-related quality of life. Readers who are interested in general topics of radiology technology assessment and cost-effectiveness analysis should consult other review articles [1-4].

Health Services Needs and Demand↗
PubMed1996

Technical adequacy of fluoroscopic spot films of the gastrointestinal tract: comparison of residents and technologists.

OBJECTIVE: We compared images obtained during gastrointestinal fluoroscopy by specially trained and experienced technologists with those obtained by radiology residents to determine if the quality of images was similar between the two groups. MATERIALS AND METHODS: Three senior radiologists examined the fluoroscopic spot films of 80 patients who were divided evenly into four groups: barium enemas performed by technologists, barium enemas performed by residents, gastrointestinal series performed by technologists, and gastrointestinal series performed by residents. The senior radiologists graded adequacy of visualization of the esophagus, stomach, duodenum, and all parts of the colon. A grade of 1 was given for poor films, 2 for adequate films, and 3 for good films. They did not know who performed each study. RESULTS: For barium enemas, the residents' mean score was slightly higher than that of the technologists (13.5 compared with 12.9). For gastrointestinal series, residents' mean score was again slightly higher (20.5 compared with 19.7). In neither case did the difference reach statistical significance. CONCLUSION: Fluoroscopic films obtained by residents and by specially trained and experienced technologists for barium enemas or gastrointestinal series were statistically indistinguishable.

Allied Health Personnel↗
PubMed2000

Feasibility of instructing radiology technologists in the performance of gastrointestinal fluoroscopy.

OBJECTIVE: We sought to determine if dedicated gastrointestinal technologists could be trained to properly perform esophagography and double-contrast barium enema examinations. SUBJECTS AND METHODS: Ninety-four patients undergoing double-contrast barium enema examinations and 123 patients undergoing esophagographic examinations were included in the study. The study was conducted over a 4-month period, with examinations performed by eight gastrointestinal technologists, 10 radiology residents, and four staff radiologists. Four random lists were generated for each set of examinations. Each staff gastrointestinal radiologist, who was unaware of who had performed the examination, independently scored the representative radiographs. RESULTS: For the double-contrast barium enema examinations, no statistically significant differences were found between the technologists and residents for amount of barium used, degree of distention, cecal opacification, and quality of spot radiographs. The technologist-performed examinations had a statistically significant lower mean fluoroscopy time (3.2 min, compared with 4.0 min for staff radiologists and 5.7 min for residents). For the esophagrams, no statistically significant differences between technologists and residents were found for single-contrast esophagrams; radiographs of the gastric cardia; assessment of motility, reflux, and transit of a solid bolus; and fluoroscopy time. Double-contrast esophagrams obtained by technologists received a better mean score than did those of the residents. CONCLUSION: Radiology technologists can be trained to perform high-quality esophagography and double-contrast barium enema examinations without an unacceptably high radiation dose.

Adult↗
PubMed2003

[Measurement of half-value layer in mammography].

The half-value layer (HVL) of an X-ray beam for film-screen mammography is considered an important parameter for image quality and patient dose. Thus, HVL must be measured in accordance with The Manual of Accuracy for Mammography printed by the Japanese Society of Radiological Technology. The manual prescribes exactly the geometry of measurement, chamber position of measurement in the field, selection of chamber, and so on. However, the measurement of HVL is difficult in the actual clinical setting. This study examined the results of failure to perform the measurement of HVL in accordance with the manual for measuring HVL in the clinical setting. The investigation indicated that serious problems do not arise when measuring HVL for routine quality control even if the chamber in the field is not always set according to the manual and if a chamber for radiotherapy or diagnosis is used that is not recommended for soft X-ray by the manual.

Female↗
PubMed2005

[A Study of uncertainty factors in cross calibration of dosimeter for diagnostic X-rays].

Although patient exposure has been increasing in recent years, few institutions have dosimeters and are able to ascertain patients' exposure dose. Internationally, however, it is necessary to adopt safety levels for patient exposure doses, and guidance levels have been introduced. Therefore, the need for measurement in areas of x-ray diagnosis has been increasing. As a result, several societies concerned with radiation dose have been endeavoring to establish a calibration system of radiation measurement and a dosimeter calibration system, which are the basics of radiation protection. Ten regional centers for standardization of doses in x-ray diagnosis were established and have begun trials relating to dosimeter cross calibration. Our institution, as one of these centers, has instituted a trial. In this study, the cross-calibration field, the reliability of the cross-calibration skill of our regional center, and the standard uncertainty of cross calibration were investigated. As a consequence of the investigation, it was determined that our cross-calibration field follows the protocol of the Japanese Society of Radiological Technology, the difference between calibration factor/cross calibration factor obtained by JQA and our regional center is within 2.5%, and the expanded uncertainty of our cross calibration is about 7.2% (k=2).

Calibration↗
PubMed1999

Radiation dose to patients and personnel during intraoperative digital subtraction angiography.

BACKGROUND AND PURPOSE: The use of intraoperative angiography to assess the results of neurovascular surgery is increasing. The purpose of this study was to measure the radiation dose to patients and personnel during intraoperative angiography and to determine the effect of experience. METHODS: Fifty consecutive intraoperative angiographic studies were performed during aneurysmal clipping or arteriovenous malformation resection from June 1993 to December 1993 and another 50 from December 1994 to June 1995. Data collected prospectively included fluoroscopy time, digital angiography time, number of views, and amount of time the radiologist spent in the room. Student's t-test was used to assess statistical significance. Effective doses were calculated from radiation exposure measurements using adult thoracic and head phantoms. RESULTS: The overall median examination required 5.2 minutes of fluoroscopy, 55 minutes of operating room use, 40 seconds of digital angiographic series time, and four views and runs. The mean room time and the number of views and runs increased in the second group of patients. A trend toward reduced fluoroscopy time was noted. Calculated effective doses for median values were as follows: patient, 76.7 millirems (mrems); radiologist, 0.028 mrems; radiology technologist, 0.044 mrems; and anesthesiologist, 0.016 mrems. CONCLUSION: Intraoperative angiography is performed with a reasonable radiation dose to the patient and personnel. The number of angiographic views and the radiologist's time in the room increase with experience.

Adolescent↗
PubMed1994

The view of a select group of leaders in radiology administration regarding the baccalaureate graduate of the future.

Radiology administrators are experts able to provide radiography educators with the input they need to produce competent graduates. This article reports on the view of a group of leaders in radiology administration regarding the need for, and the skills needed by, baccalaureate graduates in radiography to meet the needs of the future. In general, there was support for the baccalaureate graduate as an adjunct to the two-year graduate, although some felt that baccalaureate programs would provide inadequate technical preparation. The results of this research were used in a strategic plan for the development of a new baccalaureate program in radiography.

Administrative Personnel↗