The goal of this study was the preliminarily evaluation of the perception of radiographers,
engaged in a dose management program,
on the impact of an automated dose management software on the daily workflow and whether the perception of the potential advantages of the dose management program and software correlated with the perceived impact on daily workflow.
A survey for radiographers working in CT departments in 6 different outpatient radiology facilities implementing a common dose management program (Dose Excellence Project - DEP),
for at least two years,
using an automated software (DoseWatch,
The DEP team has a national project leader and each radiology facility has a radiographer appointed as the DEP contact person.
DEP was implemented using a centrally-defined basic framework adapted to local circumstances and practices.
The average number of CT examinations in the radiology facilities in 2018 was 8605 (SD: 3835; Median: 7609).
6 CT scanners were used,
a GE Revolution EVO 128SLC (GE Healthcare,
a GE BrightSpeed 16SLC (GE Healthcare),
a Siemens Somaton Sensation 64 SLC (Siemens Healthineers,
a GE Optima 660 64 SLC (GE Healthcare),
a Philips Brilliance 64 SLC (Philips Medical Systems,
Netherlands) and a Philips Ingenuity Core 64SLC (Philips Medical Systems).
An online questionnaire was sent to the 28 radiographers working in CT department and participating in the DEP team.
The participation to the survey was anonymous and voluntary.
The final received responses were 25.
The characteristics of the sample,
including relevant working experience,
are described in table 1 Fig. 1 .
Methods and measurements
This survey was developed for this study by the authors and based on the authors knowledge,
this is a unique study and,
to our knowledge,
the first publication on the perception of radiographers on the use of a dose management software and the potential advantages of a dose management program.
Two of the authors are radiographers participating in DEP,
who were involved in the questionnaire preparation,
and did not take part in the survey.
The survey included a questionnaire with demographic questions such as gender and age group,
as well as relevant working experience and workload (table 1) Fig. 1.
It was also composed by a set of questions on the potential advantages of an automated dose tracking software in a dose management program and on the perceived impact of the software in daily workflow (table 2) Fig. 2 .
Apart from a descriptive analysis,
a statistical analysis (Spearman’s Rho bilateral correlation) was performed between perceived impact on workflow,
perceived benefit to patients and workload (number of patients per CT shift).
Almost all radiographers (24/25) considered to have at minimum a reasonable knowledge of what DoseWatch is,
used it at least a moderate number of times and considered its use to have only minimal or no impact on daily workflow,
thus being able to perform all CT duties in a safely and timely manner.
all 25 respondents answered that time spent on each patient for DEP ‘activities’ (such as Alert Justification) was under 5 minutes,
with 23 answering less than 2 minutes.
When estimating the benefit of the use of DoseWatch to patients,
23 respondents considered it to have at least a moderate benefit.
No respondent answered its use to be harmful.
A greater variability was observed when considering the advantages of the use of DoseWatch in a well justified and individually tailored optimized CT examination (question 7).
12 out of 25 respondents answered that it is fundamental,
7 out of 25 that there is of a moderate benefit,
2 out of 25 that there are slight advantages and 4 out of 25 that the use of DoseWatch is neutral in this setting.
almost all of the respondents (23 out of 25) perception was that radiation dose of the majority of CT examinations performed in their facilities were within national Dose Reference Levels (DRLs) (table 3) Fig. 3 (4).
For a 0.05 significance level,
a statistically significant (r=-0.441; p=0.027) negative correlation was found between perceived impact on workflow and perceived benefit for patients.
This means that the impact on workflow is negatively associated to higher benefit for patients (table 4) Fig. 4 .
Other analyzed correlations did not have statistical significance.
The negative correlation between perceived benefit to patients and workload,
was approaching the significance level (r=-0.381; p=0.06).
It is possible that a larger sample might corroborate this correlation,
especially if a unilateral assumption (higher benefit correlates with lower workload) is considered.
The positive correlation between perceived impact in workload and number of patients per shift was not significant (r=0.249; p=0.23),
although it is possible that the latter is associated with the small sample and the relatively small proportion (7/25) of very high-volume (more than 30 patients per shift) workloads.
Further studies with larger samples would be useful to evaluate this correlation.