title: Radiation dose metrics in CT: assessing dose using the National Quality Forum CT patient safety measure.
abstract: OBJECTIVE
  The National Quality Forum (NQF) is a nonprofit consensus organization that recently endorsed a measure focused on CT radiation doses. To comply, facilities must summarize the doses from consecutive scans within age and anatomic area strata and report the data in the medical record. Our purpose was to assess the time needed to assemble the data and to demonstrate how review of such data permits a facility to understand doses.
  
  
  METHODS
  To assemble the data we used for analysis, we used the dose monitoring software eXposure to automatically export dose metrics from consecutive scans in 2010 and 2012. For a subset of 50 exams, we also collected dose metrics manually, copying data directly from the PACS into an excel spreadsheet.
  
  
  RESULTS
  Manual data collection for 50 scans required 2 hours and 15 minutes. eXposure compiled the data in under an hour. All dose metrics demonstrated a 30% to 50% reduction between 2010 and 2012. There was also a significant decline and a reduction in the variability of the doses over time.
  
  
  CONCLUSIONS
  The NQF measure facilitates an institution's capacity to assess the doses they are using for CT as part of routine practice. The necessary data can be collected within a reasonable amount of time either with automatic software or manually. The collection and review of these data will allow facilities to compare their radiation dose distributions with national distributions and allow assessment of temporal trends in the doses they are using.
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, California.
authors.forename: Jillian
authors.initials: J
authors.lastname: Keegan
authors.affiliation: Department of Public Health Sciences, University of California, Davis, California.
authors.forename: Diana L
authors.initials: DL
authors.lastname: Miglioretti
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, California.
authors.forename: Robert
authors.initials: R
authors.lastname: Gould
authors.affiliation: Office of the Chief Medical Officer, Nemours Children's Hospital, Orlando, Florida.
authors.forename: Lane F
authors.initials: LF
authors.lastname: Donnelly
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, California.
authors.forename: Nicole D
authors.initials: ND
authors.lastname: Wilson
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, California; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California. Electronic address: Nicole.Wilson@ucsf.edu.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Smith-Bindman
mesh_terms: D061214:Patient Safety / Q000592:standards*; D017410:Practice Guidelines as Topic; D011835:Radiation Protection; D011874:Radiometry / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012984:Software / Q000592:standards*; D014057:Tomography, X-Ray Computed / Q000592:standards*; D014481:United States
keywords: CT; dose metrics; quality improvement; radiation