Medical Physics and Clinical Engineering, Nottingham University Hospitals, Nottingham, NG5 1PB, United Kingdom.
Br J Radiol. 2020 Jul;93(1111):20200055. doi: 10.1259/bjr.20200055. Epub 2020 Jun 2.
To assess the accuracy and agreement of radiology information system (RIS) kerma-area product (KAP) data with respect to automatically populated dose management system (DMS) data for digital radiography (DR).
All adult radiographic examinations over 12 months were exported from the RIS and DMS at three centres. Examinations were matched by unique identifier fields, and grouped by examination type. Each centre's RIS sample completeness was calculated, as was the percentage of the RIS examination KAP values within 5% of their DMS counterparts (used as an accuracy metric). For each centre, the percentage agreement between the RIS and DMS examination median KAP values was computed using a Bland-Altman analysis. At two centres, up to 42.5% of the RIS KAP units entries were blank or invalid; corrections were attempted to improve data quality in these cases.
Statistically significant intersite variation was seen in RIS data accuracy and the agreement between the uncorrected RIS and DMS median KAP data, with a Bland-Altman bias of up to 11.1% (with a -31.7% to 53.9% 95% confidence interval) at one centre. Attempts to correct invalid KAP units increased accuracy but produced worse agreement at one centre, a slight improvement at another and no significant change in the third.
The RIS data poorly represented the DMS data.
RIS KAP data are a poor surrogate for DMS data in DR. RIS data should only be used in patient dose surveys with an understanding of its limitations and potential inaccuracies.
评估放射信息系统(RIS)比释动能面积乘积(KAP)数据相对于数字放射摄影(DR)自动填充剂量管理系统(DMS)数据的准确性和一致性。
从三个中心的 RIS 和 DMS 中导出所有超过 12 个月的成人放射学检查。通过唯一标识符字段匹配检查,并按检查类型进行分组。计算每个中心 RIS 样本完整性,以及 RIS 检查 KAP 值在其 DMS 对应值的 5%以内的百分比(用作准确性指标)。对于每个中心,使用 Bland-Altman 分析计算 RIS 和 DMS 检查中位数 KAP 值之间的百分比一致性。在两个中心,高达 42.5%的 RIS KAP 单位条目是空白或无效的;在这些情况下,尝试进行更正以提高数据质量。
在 RIS 数据准确性以及未校正的 RIS 和 DMS 中位数 KAP 数据之间的一致性方面,观察到站点间存在显著的差异,在一个中心,Bland-Altman 偏差高达 11.1%(95%置信区间为-31.7%至 53.9%)。尝试更正无效的 KAP 单位提高了准确性,但在一个中心产生了较差的一致性,在另一个中心略有改善,而在第三个中心没有显著变化。
RIS 数据不能很好地代表 DMS 数据。
在 DR 中,RIS KAP 数据是 DMS 数据的一个很差的替代品。在了解其局限性和潜在误差的情况下,仅应将 RIS 数据用于患者剂量调查。