PMID- 28084504
OWN - NLM
STAT- MEDLINE
DCOM- 20171012
LR  - 20181113
IS  - 1432-1998 (Electronic)
IS  - 0301-0449 (Linking)
VI  - 47
IP  - 4
DP  - 2017 Apr
TI  - Quality of pediatric abdominal CT scans performed at a dedicated children's 
      hospital and its referring institutions: a multifactorial evaluation.
PG  - 391-397
LID - 10.1007/s00247-016-3768-7 [doi]
AB  - BACKGROUND: Pediatric patients requiring transfer to a dedicated children's 
      hospital from an outside institution may undergo CT imaging as part of their 
      evaluation. Whether this imaging is performed prior to or after transfer has been 
      shown to impact the radiation dose imparted to the patient. Other quality 
      variables could also be affected by the pediatric experience and expertise of the 
      scanning institution. OBJECTIVE: To identify differences in quality between 
      abdominal CT scans and reports performed at a dedicated children's hospital, and 
      those performed at referring institutions. MATERIALS AND METHODS: Fifty 
      consecutive pediatric abdominal CT scans performed at outside institutions were 
      matched (for age, gender and indication) with 50 CT scans performed at a 
      dedicated freestanding children's hospital. We analyzed the scans for technical 
      parameters, report findings, correlation with final clinical diagnosis, and 
      clinical utility. Technical evaluation included use of intravenous and oral 
      contrast agents, anatomical coverage, number of scan phases and size-specific 
      dose estimate (SSDE) for each scan. Outside institution scans were re-reported 
      when the child was admitted to the children's hospital; they were also 
      re-interpreted for this study by children's hospital radiologists who were 
      provided with only the referral information given in the outside institution's 
      report. Anonymized original outside institutional reports and children's hospital 
      admission re-reports were analyzed by two emergency medicine physicians for ease 
      of understanding, degree to which the clinical question was answered, and level 
      of confidence in the report. RESULTS: Mean SSDE was lower (8.68) for children's 
      hospital scans, as compared to outside institution scans (13.29, P = 0.03). 
      Concordance with final clinical diagnosis was significantly lower for original 
      outside institution reports (38/48, 79%) than for both the admission and study 
      children's hospital reports (48/50, 96%; P = 0.005). Children's hospital 
      admission reports were rated higher than outside institution reports for 
      completeness, ease of understanding, answering of clinical question, and level of 
      confidence of the report (P < 0.001). CONCLUSION: Pediatric abdominal CT scans 
      performed and interpreted at a dedicated children's hospital are associated with 
      higher technical quality, lower radiation dose and a more clinically useful 
      report than those performed at referring institutions.
FAU - Snow, Aisling
AU  - Snow A
AUID- ORCID: 0000-0002-6406-6215
AD  - Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, 
      MA, 02115, USA. aislingsnow@gmail.com.
AD  - Department of Radiology, Our Lady's Children's Hospital, Crumlin, Dublin, 
      Ireland. aislingsnow@gmail.com.
FAU - Milliren, Carly E
AU  - Milliren CE
AD  - Program for Patient Safety and Quality, Boston Children's Hospital, Boston, MA, 
      USA.
FAU - Graham, Dionne A
AU  - Graham DA
AD  - Program for Patient Safety and Quality, Boston Children's Hospital, Boston, MA, 
      USA.
FAU - Callahan, Michael J
AU  - Callahan MJ
AD  - Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, 
      MA, 02115, USA.
FAU - MacDougall, Robert D
AU  - MacDougall RD
AD  - Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, 
      MA, 02115, USA.
FAU - Robertson, Richard L
AU  - Robertson RL
AD  - Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, 
      MA, 02115, USA.
FAU - Taylor, George A
AU  - Taylor GA
AD  - Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, 
      MA, 02115, USA.
LA  - eng
PT  - Journal Article
DEP - 20170113
PL  - Germany
TA  - Pediatr Radiol
JT  - Pediatric radiology
JID - 0365332
SB  - IM
MH  - Child
MH  - Female
MH  - *Hospitals, Pediatric
MH  - Humans
MH  - Male
MH  - Quality Assurance, Health Care/*statistics & numerical data
MH  - Radiography, Abdominal/*standards
MH  - *Referral and Consultation
MH  - Tomography, X-Ray Computed/*standards
OTO - NOTNLM
OT  - Abdomen
OT  - Appendicitis
OT  - Children
OT  - Computed tomography
OT  - Quality
OT  - Radiation
OT  - Trauma
EDAT- 2017/01/14 06:00
MHDA- 2017/10/13 06:00
CRDT- 2017/01/14 06:00
PHST- 2016/07/27 00:00 [received]
PHST- 2016/12/13 00:00 [accepted]
PHST- 2016/10/11 00:00 [revised]
PHST- 2017/01/14 06:00 [pubmed]
PHST- 2017/10/13 06:00 [medline]
PHST- 2017/01/14 06:00 [entrez]
AID - 10.1007/s00247-016-3768-7 [pii]
AID - 10.1007/s00247-016-3768-7 [doi]
PST - ppublish
SO  - Pediatr Radiol. 2017 Apr;47(4):391-397. doi: 10.1007/s00247-016-3768-7. Epub 2017 
      Jan 13.