title: Quality assurance: a comparison study of radiographic exposure for neonatal chest radiographs at 4 academic hospitals.
abstract: BACKGROUND
  Little is known about exposure differences among hospitals. Large differences might identify outliers using excessive exposure.
  
  
  OBJECTIVE
  We used the newly described exposure index and deviation index to compare the difference in existing radiographic exposures for neonatal portable chest radiographs among four academic children's hospitals.
  
  
  METHODS
  For each hospital we determined the mean exposure index. We also set target exposure indices and then measured the deviation from this target.
  
  
  RESULTS
  There was not a large difference in exposure index among sites. No site had an exposure index mean that was more than twice or less than half that of any other site. For all four sites combined, 92% of exposures had a deviation index within the range from -3 to +3. Thus exposures at each hospital were consistently within a reasonable narrow spectrum.
  
  
  CONCLUSIONS
  Mean exposure index differences are caused by operational differences with mean values that varied by less than 50% among four hospitals. Ninety-two percent of all exposures were between half and double the target exposure. Although only one vendor's equipment was used, these data establish a practical reference range of exposures for neonatal portable radiographs that can be recommended to other hospitals for neonatal chest radiographs.
authors: Department of Radiology, Indiana University, Riley Hospital for Children, 702 Barnhill Drive, Rm 1053, Indianapolis, IN 46202, USA. mecohen@iupui.edu
authors: Mervyn D
authors: MD
authors: Cohen
authors: Richard
authors: R
authors: Markowitz
authors: Jeanne
authors: J
authors: Hill
authors: Walter
authors: W
authors: Huda
authors: Paul
authors: P
authors: Babyn
authors: Bruce
authors: B
authors: Apgar
mesh_terms: D000046:Academic Medical Centers / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*; D011829:Radiation Dosage; D013902:Radiography, Thoracic / Q000592:standards* / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed / Q000592:standards* / Q000706:statistics & numerical data*; D014481:United States