A comparison of manually populated radiology information system digital radiographic data with electronic dose management systems.

Abstract

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.