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Personalized Technologist Dose Audit Feedback for Reducing Patient Radiation Exposure From CT

  • Miglioretti, Diana L.
  • Zhang, Yue
  • Johnson, Eric
  • Lee, Choonsik
  • Morin, Richard L.
  • Vanneman, Nicholas
  • Smith-Bindman, Rebecca1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 14, 16, 17, 14
  • 1 Division of Biostatistics
  • 2 Department of Public Health Sciences
  • 3 University of California, Davis
  • 4 Group Health Research Institute
  • 5 Division of Epidemiology
  • 6 Department of Internal Medicine
  • 7 University of Utah
  • 8 Division of Cancer Epidemiology and Genetics
  • 9 National Cancer Institute
  • 10 National Institute of Health
  • 11 Department of Radiology
  • 12 Mayo Clinic
  • 13 Department of Radiology and Biomedical Imaging
  • 14 University of California, San Francisco
  • 15 Department of Epidemiology and Biostatistics
  • 16 Department of Obstetrics
  • 17 Gynecology and Reproductive Sciences
Published Article
Journal of the American College of Radiology
Publication Date
Jan 01, 2014
DOI: 10.1016/j.jacr.2013.10.017


PurposeThe 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. MethodsThis 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. ResultsFor 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. ConclusionsPersonalized audit feedback and education can change technologists' attitudes about, and awareness of, radiation and can lower patient radiation exposure from CT imaging.

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