title: Variation in the quality of lumbar spine MR images in Washington State.
abstract: OBJECTIVE
  To investigate the variation in quality of lumbar spine magnetic resonance (MR) images as a function of type of ownership of the imaging center, number of studies performed per month, specialty training of the image interpreter, and field strength of the MR unit.
  
  
  METHODS
  Data were collected from all imaging facilities in western Washington state that received reimbursement from the Washington State Health Care Authority. Three readers with expertise in spine imaging, who were blinded to center and patient identification information, rated the technical image quality of each study. All MR images of the lumbar spine (maximum of six) paid for by the health care authority were evaluated. If a center had performed more than six studies, then six were randomly selected for evaluation.
  
  
  RESULTS
  Variation in quality scores among sites was significant (P =.001). Field strength was the strongest predictor of better quality. Poorer quality was associated with for-profit ownership, a larger number of radiologists at the site reading MR images, and a larger percentage of studies checked by a radiologist prior to the end of the examination.
  
  
  CONCLUSIONS
  There was significant variation in the quality of MR images of the lumbar spine, and at least a portion of this variation was attributable to characteristics of the imaging center.
authors.affiliation: Department of Radiology, School of Medicine, Health Services Research School of Public Health, Seattle, WA 98195, USA. jarvikj@u.washington.edu
authors.forename: J G
authors.initials: JG
authors.lastname: Jarvik
authors.forename: W D
authors.initials: WD
authors.lastname: Robertson
authors.forename: F
authors.initials: F
authors.lastname: Wessbecher
authors.forename: K
authors.initials: K
authors.lastname: Reger
authors.forename: C
authors.initials: C
authors.lastname: Solomon
authors.forename: R
authors.initials: R
authors.lastname: Whitten
authors.forename: T
authors.initials: T
authors.lastname: Lumley
authors.forename: R A
authors.initials: RA
authors.lastname: Deyo
mesh_terms: D000554:Ambulatory Care Facilities / Q000191:economics / Q000458:organization & administration / Q000592:standards; D000704:Analysis of Variance; D003697:Delphi Technique; D004867:Equipment Design; D005544:Forecasting; D006801:Humans; D007349:Insurance, Health, Reimbursement; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000592:standards* / Q000706:statistics & numerical data; D008280:Magnetics; D015999:Multivariate Analysis; D015588:Observer Variation; D010067:Ownership; D011787:Quality of Health Care; D011871:Radiology / Q000193:education / Q000706:statistics & numerical data; D016037:Single-Blind Method; D014861:Washington