Quality and Safety Monitoring of Clinical Computed Tomography Practice

临床计算机断层扫描实践的质量和安全监测

基本信息

批准号：
10253256
负责人：
Francesco Ria
金额：
$ 24.97万
依托单位：
METIS HEALTH ANALYTICS, LLC
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-18 至 2022-09-17
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10253256
关键词：
Address Affect Age Algorithms Architecture Caring Clinical Collection Computer software Contrast Media Country Data Data Analyses Data Storage and Retrieval Database Management Systems Dental Development Devices Diagnostic radiologic examination Disease Dose Ensure Equilibrium Equipment Exposure to Fluoroscopy Foundations Goals Health Health Technology Health care facility Health system Healthcare Hospitals Human Image Individual Information Systems Infrastructure Injury Insurance Intuition Knowledge Mammography Manufacturer Name Medical Imaging Medicare Modeling Monitor Nuclear Online Systems Outcome Patient Care Patient imaging Patients Performance Phase Phase Transition Population Protocols documentation Provider Quality of Care Radiation Radiation Dose Unit Radiation exposure Radiology Specialty Reporting Research Risk Roentgen Rays Safety Scanning Small Business Innovation Research Grant Standardization Structure System Techniques Technology Testing United States Universities X-Ray Computed Tomography base beneficiary clinical imaging clinical implementation clinical practice commercialization computer infrastructure cost dashboard data exchange data management data visualization design graphical user interface imaging modality imaging system improved informatics infrastructure innovation insight interoperability machine learning method operation patient safety profiles in patients programs prototype radiation risk repaired software as a service tool

项目摘要

Abstract – Fifty percent of radiation exposure to the United States population is from medical imaging, half of which come from over 80 million computed tomography (CT) scans performed every year. This significant use has raised notable concerns regarding utilization costs, inappropriate applications, and the associated radiation risk. A recent Medicare reports hundreds of hospitals across the country have needlessly scanned their patients twice on the same day. Unnecessary repeated scans expose patients to extra radiation while increase expense, decrease reimbursement, and increase liability for the providers. Thus, the legislative and regulatory organizations have encouraged and mandated stricter oversight of medical imaging usage and its associated radiation. Concurrent to the mandate to better manage imaging risk is to ensure its value: One of the quintessential but most understated pillars of current CT practice is CT’s high value in caring for illness and injury across all ages. To ensure this benefit of CT examinations, there needs to be a careful balance between image quality and radiation safety. A poor quality, overly low dose exam is a disservice to the care of the patient while an exam with more radiation dose than necessary can undermine its safety. Therefore, proper CT imaging requires a comprehensive combined quality and dose monitoring program on a patient-by-patient basis to properly understand, manage, and mitigate radiation risk. Unfortunately, currently there is no such software available in the market that can simultaneously monitor CT radiation dose and its corresponding image quality. The objective of this fast-track project is to develop a first Software as a Service (SaaS)-based performance monitoring platform to track radiation dose and image quality concurrently. The platform aims to provide essential data and insight to improve CT performance through considering both patient safety and imaging quality simultaneously. Specifically, the project will develop a product that offers 1) a robust multi-infrastructure workflow to connect and collect clinical CT quality- and dose-relevant data; 2) a suite of patient-specific CT radiation dose and image quality assessment algorithms; 3) an implementation of a task manager to chain and automate dose and image quality calculations towards CT performance assessment; 4) a combined SQL- NoSQL database system for structured and un-structured quality- and dose-relevant data storage; and 5) a web-based dashboard for interactive and easy-to-use data analysis and visualization. The development utilizes machine-learning methodologies to devise robust and scalable techniques for extracting meaningful knowledge from hundreds of thousands of patient images. The system quantifies value for a value-based practice. It serves as an essential tool to minimize variability in quality and dose across a practice, to ensure consistent use of CT technology, and to ensure imaging radiation dose and quality levels match expected values. The system will be beta tested at healthcare facilities paving the way toward effective commercialization. 1

摘要 – 美国人口 50% 的辐射暴露来自医学成像，其中一半来自医学成像。这些数据来自每年超过 8000 万次计算机断层扫描 (CT) 扫描，这一重要用途。引起了人们对使用成本、不当应用以及相关辐射的关注最近的一份医疗保险报告称，全国数百家医院对其进行了不必要的扫描。患者在同一天进行两次不必要的重复扫描会使患者暴露在额外的辐射下，同时增加。费用，减少报销，并增加提供者的责任。各组织鼓励并强制要求对医学成像的使用及其相关产品进行更严格的监督更好地管理成像风险的同时，还要确保其价值：其中之一。当前 CT 实践的典型但最低调的支柱是 CT 在治疗疾病和治疗方面的高价值为了确保 CT 检查的益处，需要在不同年龄段之间进行仔细的平衡。图像质量和辐射安全性差、剂量过低的检查不利于患者的护理。患者接受超过必要的辐射剂量的检查可能会损害其安全性。成像需要对每个患者进行全面的综合质量和剂量监测计划不幸的是，目前还没有这样的基础来正确理解、管理和减轻辐射风险。市场上有软件可以同时监测CT辐射剂量及其相应的图像质量。该快速通道项目的目标是开发第一个基于软件即服务 (SaaS) 的性能同时跟踪辐射剂量和图像质量的监测平台该平台旨在提供。通过考虑患者安全和成像来提高 CT 性能的重要数据和见解具体来说，该项目将开发一种产品，该产品提供 1) 强大的多基础设施。连接和收集临床 CT 质量和剂量相关数据的工作流程 2) 一套患者特异性 CT；辐射剂量和图像质量评估算法；3) 任务管理器的实现，以链接和自动计算 CT 性能评估的剂量和图像质量；4) 组合 SQL- 用于结构化和非结构化质量和剂量相关数据存储的 NoSQL 数据库系统；以及 5) a 该开发利用基于网络的仪表板进行交互式且易于使用的数据分析和可视化。机器学习方法设计强大且可扩展的技术来提取有意义的知识该系统从数十万张患者图像中量化了基于价值的实践的价值。作为一个重要的工具，可以最大限度地减少实践中质量和剂量的变化，以确保一致利用CT技术，并确保成像辐射剂量和质量水平符合预期值。系统将在医疗机构进行 Beta 测试，为有效的商业化铺平道路。 1