title: Personalized technologist dose audit feedback for reducing patient radiation exposure from CT.
abstract: OBJECTIVE
  The aim of this study was to determine whether providing radiologic technologists with audit feedback on doses from CT examinations they conduct and education on dose-reduction strategies reduces patients' radiation exposure.
  
  
  METHODS
  This prospective, controlled pilot study was conducted within an integrated health care system from November 2010 to October 2011. Ten technologists at 2 facilities received personalized dose audit reports and education on dose-reduction strategies; 9 technologists at a control facility received no intervention. Radiation exposure was measured by the dose-length product (DLP) from CT scans performed before (n = 1,630) and after (n = 1,499) the intervention and compared using quantile regression. Technologists were surveyed before and after the intervention.
  
  
  RESULTS
  For abdominal CT, DLPs decreased by 3% to 12% at intervention facilities but not at the control facility. For brain CT, DLPs significantly decreased by 7% to 12% at one intervention facility; did not change at the second intervention facility, which had the lowest preintervention DLPs; and increased at the control facility. Technologists were more likely to report always thinking about radiation exposure and associated cancer risk and optimizing settings to reduce exposure after the intervention.
  
  
  CONCLUSIONS
  Personalized audit feedback and education can change technologists' attitudes about, and awareness of, radiation and can lower patient radiation exposure from CT imaging.
authors.affiliation: Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, Davis, California; Group Health Research Institute, Seattle, Washington. Electronic address: dmiglioretti@ucdavis.edu.
authors.forename: Diana L
authors.initials: DL
authors.lastname: Miglioretti
authors.affiliation: Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah.
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Group Health Research Institute, Seattle, Washington.
authors.forename: Eric
authors.initials: E
authors.lastname: Johnson
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Bethesda, Maryland.
authors.forename: Choonsik
authors.initials: C
authors.lastname: Lee
authors.affiliation: Department of Radiology, Mayo Clinic, Jacksonville, Florida.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Morin
authors.affiliation: Group Health Research Institute, Seattle, Washington.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Vanneman
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Smith-Bindman
mesh_terms: D054869:Clinical Audit; D004496:Education, Continuing / Q000706:statistics & numerical data*; D005246:Feedback; D017056:Medical Laboratory Personnel / Q000706:statistics & numerical data*; D011829:Radiation Dosage; D011835:Radiation Protection / Q000706:statistics & numerical data*; D011871:Radiology / Q000706:statistics & numerical data*; D011874:Radiometry / Q000706:statistics & numerical data; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014481:United States
keywords: CT; audit feedback; radiation exposure; radiologic technologists