Jenifer Willmann Siegelman MD, MPH, Presenter: Consultant, Bayer AG

Matthew M. Raffol MA, Abstract Co-Author: Nothing to Disclose

Mohammad Hadi Bagheri MD, Abstract Co-Author: Nothing to Disclose

Ramin Khorasani MD, Abstract Co-Author: Consultant, Medicalis Corp

Aaron D. Sodickson MD, PhD, Abstract Co-Author: Research Grant, Siemens AG

Systematic review of CT protocols for patient safety and quality improvement requires consistent, accurate, and intelligible protocol naming. Our goal was to assess naming consistency of our CT protocols via adherence to RadLex body region convention.

CT protocol names used in our multi-institution hospital system over a 27-month period (2012-2014) were assessed for conformance to the RadLex Playbook naming conventions. 193,000 consecutive CT exams at three institutions on 12 scanners from two vendors with 1622 unique protocol names were examined. Scanner protocol names for the head, neck, abdomen, chest, and spine were manually mapped to RadLex. Single body region clinical protocol names (n=848) were assessed for inclusion of the relevant RadLex body region designation.

54% of protocol names contained the RadLex-prescribed term for body region. Chi-squared tests for independence detected statistically significant variation in conformance rates across body regions (p < .001) or scanners (p<.005). No significant difference was detected among institutions (p<.8). Body region conformance rates were: neck 100%, spine 98%, head 53%, chest 81%, and abdomen 31%. Variation within a single protocol type (unique RadLex ID) was also observed, with as many as 19 unique names across the 3 institutions. Many protocols also deviated from the RadLex conventions by including reference to patient weight categories, contrast timing, clinical indication (PE, stent hypervascular) and number of scanner passes.

Variable naming of CT scanner protocols is prevalent within our healthcare system. In the context of accreditation standards, quality improvement and patient safety, healthcare-system wide review of CT protocols to assess the appropriateness of scan parameters and radiation exposure is necessary but is hampered by the current lack of protocol naming standardization due to suboptimal adherence to conventions. Additional modifiers beyond the RadLex terminology may be required to adequately reflect the complexity and diversity of protocol specifications needed for clinical operations. Character limits on scanners may also inhibit full and standardized parameter-specification in all protocol names.

Increased standardization of protocol nomenclature (using Radlex) may enable quality improvement initiatives by facilitating health-system wide protocol review and optimization.

Siegelman, J, Raffol, M, Bagheri, M, Khorasani, R, Sodickson, A, Adherence to Standard Nomenclature in CT Protocols: Assessing Consistency of Existing Naming Conventions Used in Clinical Operations.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016116.html