title: Evaluating data capture methods for the establishment of diagnostic reference levels in CT scanning.
abstract: OBJECTIVE
  Concerns about the radiation dose associated with CT scanning have led to a call for establishment of diagnostic reference levels. Self-complete surveys have been used extensively to gather this information, however, departmental Radiological Information System's/Picture Archive Communication Systems (RIS/PACS) also hold this information. We compared dosimetry derived from survey with that using RIS/PACSs.
  
  
  METHODS
  Technical data were collected from a large metropolitan tertiary hospital in WA using both data collection methods for a range of adult CT scanning examinations. Radiation dose was calculated from both datasets and the results evaluated for several indexes of inter-rater agreement.
  
  
  RESULTS
  Radiation dose calculated using self-report survey data differed both systematically and proportionally from that calculated using RIS/PACS data. Differences were not consistent across CT examination type and thus not amenable to simple correction. The disparity was greater and more variable for organ dose than effective dose due to reliance of survey data on "generic" anatomical start and stop limits compared with actual data available on RIS/PACS.
  
  
  CONCLUSIONS
  The bias observed in our study indicates that care should be taken when interpreting the results of studies measuring radiation dose using self-complete surveys. The availability of electronic databases that include information required for the evaluation and monitoring of CT radiation dose provides the opportunity to capture better quality data in a cost-effective manner. We recommend that national and local databases are established that routinely capture these data so as to facilitate the development and monitoring of radiation dose associated with CT scanning.
authors: Centre for Population Health Research, Faculty of Health Science, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia; Centre for Health Services Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia. Electronic address: r.moorin@curtin.edu.au.
authors: Rachael E
authors: RE
authors: Moorin
authors: Centre for Health Services Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia. Electronic address: david.gibson@uwa.edu.au.
authors: David A J
authors: DA
authors: Gibson
authors: Department of Medical Imaging Science, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia. Electronic address: rene.forsyth@postgrad.curtin.edu.au.
authors: Rene K
authors: RK
authors: Forsyth
authors: Institute of Health Research, University of Notre Dame, 19 Mouat Street, Fremantle, Western Australia 6959, Australia. Electronic address: max.bulsara@nd.edu.au.
authors: Max K
authors: MK
authors: Bulsara
authors: Centre for Health Services Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia 6009, Australia. Electronic address: darcy.holman@uwa.edu.au.
authors: C D'Arcy J
authors: CD
authors: Holman
mesh_terms: D016208:Databases, Factual / Q000592:standards* / Q000706:statistics & numerical data; D004282:Documentation / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D016247:Information Storage and Retrieval / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D011829:Radiation Dosage; D011871:Radiology / Q000592:standards; D011873:Radiology Information Systems / Q000592:standards* / Q000706:statistics & numerical data; D011874:Radiometry / Q000592:standards* / Q000706:statistics & numerical data; D012016:Reference Values; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards*; D014904:Western Australia
keywords: CT scan; Radiation dosage; Radiation dosimetry; Radiology information systems; Survey methods