title: Clinical intervention for quality improvement of gastric-emptying studies.
abstract: Prompted by clinical concerns for false-negative tests, we implemented a clinical intervention consisting of a training session and an image-based verification procedure to document homogeneous radioactivity distribution in the radiolabeled meal (egg substitute per the guideline).
  
  
  METHODS
  A technologist training session emphasized the importance of thorough mixing of (99m)Tc-sulfur colloid in the egg meal. For 6 mo after training, an image of the prepared mixed egg was acquired before patient ingestion. Consecutive gastric-emptying studies performed 6 mo before and after training were reviewed by 2 experienced physicians.
  
  
  RESULTS
  There were 7 abnormal and 44 normal studies before and 15 abnormal and 29 normal studies after training (P < 0.05). Subjective evaluations of images for meal-mixing quality by 2 readers correlated with each other and with an objective measure of expected gastric-emptying physiology (correlation coefficients, 0.54 and 0.38, respectively).
  
  
  CONCLUSIONS
  The described clinical intervention improved the accuracy of our gastric-emptying studies by decreasing false-negative studies.
authors.affiliation: Department of Nuclear Medicine, VAMC Atlanta, 1670 Clairmont Rd., Decatur, Georgia; and Department of Radiology and Imaging Sciences, Emory University, 1364 Clifton Rd., Atlanta, Georgia dvbonta@yahoo.com.
authors.forename: Dacian V
authors.initials: DV
authors.lastname: Bonta
authors.affiliation: Department of Nuclear Medicine, VAMC Atlanta, 1670 Clairmont Rd., Decatur, Georgia; and Department of Radiology and Imaging Sciences, Emory University, 1364 Clifton Rd., Atlanta, Georgia.
authors.forename: David C
authors.initials: DC
authors.lastname: Brandon
authors.affiliation: Department of Nuclear Medicine, VAMC Atlanta, 1670 Clairmont Rd., Decatur, Georgia; and Department of Radiology and Imaging Sciences, Emory University, 1364 Clifton Rd., Atlanta, Georgia.
authors.forename: Jeranfel
authors.initials: J
authors.lastname: Hernandez
authors.affiliation: Department of Nuclear Medicine, VAMC Atlanta, 1670 Clairmont Rd., Decatur, Georgia; and.
authors.forename: Minesh
authors.initials: M
authors.lastname: Patel
authors.affiliation: Department of Nuclear Medicine, VAMC Atlanta, 1670 Clairmont Rd., Decatur, Georgia; and.
authors.forename: Sandra
authors.initials: S
authors.lastname: Grant
authors.affiliation: Department of Nuclear Medicine, VAMC Atlanta, 1670 Clairmont Rd., Decatur, Georgia; and Department of Radiology and Imaging Sciences, Emory University, 1364 Clifton Rd., Atlanta, Georgia.
authors.forename: Naomi
authors.initials: N
authors.lastname: Alazraki
mesh_terms: D005188:False Negative Reactions; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D058996:Quality Improvement; D011877:Radionuclide Imaging / Q000379:methods*; D013671:Technetium Tc 99m Sulfur Colloid
chemical_list: D013671:Technetium Tc 99m Sulfur Colloid
keywords: Tougas protocol; gastric-emptying scintigraphy; quality assurance; quality improvement