Affordable Access

Access to the full text

European guidelines on radiographic image quality in chiropractic practice – proposal of a cross-sectional graded classification reporting principle

Authors
  • Doktor, Klaus1, 2, 3
  • Vilholm, Maria Lind2
  • Hardardóttir, Aldis4
  • Christensen, Henrik Wulff3
  • Lauritsen, Jens5
  • 1 University of Southern Denmark, Campusvej 55, Odense M, 5250, Denmark , Odense M (Denmark)
  • 2 Back Center Midwestern Jutland, Dalgas Allé 2A, Herning, 7400, Denmark , Herning (Denmark)
  • 3 Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, Odense M, 5230, Denmark , Odense M (Denmark)
  • 4 Private Chiropractic Practice, Reykjavik, Iceland , Reykjavik (Iceland)
  • 5 Institute of Clinical Medicine, University of Southern Denmark and Orthopedic Department, Odense University Hospital, Odense, Denmark , Odense (Denmark)
Type
Published Article
Journal
Chiropractic & Manual Therapies
Publisher
BioMed Central
Publication Date
May 26, 2021
Volume
29
Issue
1
Identifiers
DOI: 10.1186/s12998-021-00375-4
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThe Commission of the European Communities (CEC) has published: European Guidelines on Quality Criteria for Diagnostic Radiographic Images. These guidelines are considered a gold standard, recommended for use in quality assurance protocols.The objectives of this study: 1) Propose a graded classification format for Danish chiropractic clinics according to the CEC-quality criteria for diagnostic radiographic images of the lumbar spine. 2) Propose a reporting principle for quality of radiographic images. 3) Document variation in radiation exposure among clinics.MethodsThis is a cross-sectional study of image quality based on random sampling from 148 chiropractic clinics. Clinics were included if using: 1) Digital radiography and 2) The chiropractic picture and archiving system (KirPACS) at the Nordic Institute of Chiropractic and Clinical Biomechanics (NIKKB) in Denmark. A sample of 296 lumbar spine series were randomly collected from KirPACS (January 2018). Two independent observers reviewed 50 lumbar spine series twice with a 4-week interval, testing intra- and inter-observer reproducibility. The same observers then reviewed the remaining 246 radiographic studies. All studies were evaluated using the CEC Quality Criteria. Patient radiation dose values were retrieved from KirPACS (First quarter of 2020).ResultsA reporting and classification principle of diagnostic image quality was used in 148 chiropractic clinics. Compliance with the 22 CEC Quality Criteria had proportions ranging from 0.72–0.96 for 18 criteria, while 4 criteria specifying detail and definition ranged between 0.20–0.66. The proposed rating system (A to E) revealed: 18 A clinics, 28 B clinics, 32 C clinics, 25 D clinics and 45 E clinics (A = highest quality; E = lowest quality). The patient radiation reference dose in Denmark is 7 mGy for the AP/PA lumbar spine. Very few clinics exceed the reference dose value, approximately 50% of clinics were below 5 mGy.ConclusionA reporting principle is proposed for a graded classification format based on the CEC-quality criteria for diagnostic radiographic images of the lumbar spine. The Quality Criteria are for the most part met satisfactorily in 148 Danish chiropractic clinics, but important image details are compromised, in most cases, because of low patient radiation doses. The results of a patient radiation dose survey enabled documentation of variation in radiation exposure among chiropractic clinics.

Report this publication

Statistics

Seen <100 times