Standardized DIR Report User Guide

Transcription

1 The American College of Radiology Standardized DIR Report User Guide An Interactive Reporting Tool 8/21/2015 American College of Radiology 1891 Preston White Drive Reston, VA Copyright 2013, American College of Radiology. All rights reserved

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3 Contents 1. Introduction Getting Started Exam Search Scatter plot over time Box Plot By Scanner Box Plot by rpid/study description Summary comparison Page 2

4 1. INTRODUCTION The purpose of the Standardized DIR Report tool is to provide a user friendly reporting tool which can be searched by values not available in other DIR reporting tools. The list of search categories is: 1. Exam Search 2. Scatter Plot Over Time 3. Box Plot by Scanner 4. Box Plot by RPID/Study Description 5. Summary Comparisons Each category provides futher granularity for each CT exam through the following search options: 1. Order by 2. Record Display 3. Age Group 4. From To date range 5. Scanner 6. RPID (Radlex Playbook ID number) 7. Study Description 8. Study Instance UID 9. Dose Values or dose index measures,* a. CTDIvol max across scans b. CTDIvol Total for exam c. SSDE max across scans d. SSDE Total for exam e. DLP max across scans f. DLP Total for exam 10. Dose Values greater-than or equal-to *These Dose Value search options are not available for Exam Search because the results of Exam Search include all of these measures. 2. GETTING STARTED Log in to your NRDR facility using your log in characteristics: Facilty ID number, User Type, User Name and your password at the NRDR portal. Page 3

5 NRDR Portal Log In After a successful log in, locate the DIR link on the menu on the left-hand side of the page. Click on the DIR link so that the menu expands to display DIR related links. Locate Standardized Dose Index Reports on the menu and click to open. DIR Menu Link and Standardized DIR Reports Link Note: The NRDR portal may require you to provide your password once more before the Standardized DIR report page will launch. Simply click on Login to proceed. Second Login Screen Page 4

6 The purpose of the Standardized DIR Reports is to provide reports that use processed and standardized data that are identical to what is used for the semi-annual Feedback reports. These reports incorporate the information from localizers to calculate size-specific dose estimates (SSDE), normalize dose indices based on phantom size for fair comparison with other facilities, apply the RadLex Playbook IDs (RPID) to which you have mapped facility study descriptions, and exclude inapplicable data such as dose indices associated with timing runs. More information on this process is available in a publication posted on the DIR website. You can run a report using any of your data and recover a report that would match the Feedback reports, for any interim period between the release dates of the quarterly or semi-annual reports. The Summary Comparisons tool now produces a report on-demand that is identical to the Executive Summary report or the Excel Spreadsheet reports. Please keep in mind as you use these reports, that the results of your search will not match any search conducted through a non-standardized DIR Report. The non-standardized report contains information from the raw data submitted by your facility before we standardize them. The following Standardized DIR screen will launch to display the five report options: Report Options Select one of the report options available and click on the desired link. After doing so, the report page will launch. Once the new page has launched, click on the report option of your choice. Note: It is important to understand that it will take approximately one week s worth of processing within NRDR to standardize the exam data. That is, any search you conduct on data submitted to our central server within the previous week may not be accurate. Please adjust your search accordingly. Page 5

7 3. EXAM SEARCH Standardized DIR Report User Guide Conduct an Exam Search using the following options: Create a search by either selecting or deselecting variables such as Adult vs. Pediatric, RPID vs. Study, or All scanners vs. individual scanners. A search example is provided below. Exam Search Sample The exam search results will display on the right. Export to Excel using the Excel button in the right-hand corner. The data can be sorted and viewed with greater ease. Page 6

8 Exam Search Results For more information about a particular exam, click on the Detail button. A CT Exam Detail report will launch. To leave this screen and return to the report page, click the X in the right-hand corner to delete the screen. Page 7

9 CT Exam Detail report: In the sample provided below, the exam detail provides the time of the exam, the location of the CT scanner, the dose indices for the patient exam, the series, device and patient information. Exam Detail Sample Page 8

10 4. SCATTER PLOT OVER TIME Standardized DIR Report User Guide You may choose to view your data using a scatter plot. This option allows the user to view data by selecting the date range, the RPID or Study Description, Adult vs Pediatric, CT Scanner and unit of measure (CTDIvol, DLP, and SSDE). There are two ways to access the scatter plot. If you have already logged in to the DIR and are presently using the Standardized DIR tool, simply look for the Scatter Plot Over Time on the upper tab. (see below) Selecting Scatter Plots Using the Tab on the Menu Or, if you are logging in, then click on the Scatter Plot Over Time hypertext link (see below). Remember that data will not populate the same day your facility sends exam data. Please allow up to 7 days for your data to post to this reporting tool. Selecting Scatter Plots from the Standardized DIR Main Page Page 9

11 Example 1: Conducting a Scatter Plot Over Time w SSDE & Study Description, Adult & Pediatric Search The search by scatter plot is a useful tool for determining if your CT scanners have been sending localizers (often referred to as tomograms or scouts) in additional to viewing exam data by using three units of measure, the CTDIvol, DLP, SSDE (max & total). To obtain the scatter plot below use the following search criteria: SSDE Max across scans Pediatric Date Range (left open to search all data submitted) Selecting scanners (blocked for privacy) Study Description All Example One: Scatter Plot Over Time Search Result Page 10

12 Notice that the Data Type selection drop down box is at the top of the screen, whereas this field is at the bottom of the screen when conducting an Exam Search. There is no Ordered by option either as the data can only be displayed in a scatter plot configuration chronologically. The visual display will list all scanners selected for a search specified by a date range (Scanners were blocked for privacy) and the adult & pediatric exam data were grouped according to age. Note: The list of scanners will display beneath the scatter plot if it was selected as part of the search criteria. This does not mean that all scanners in the display contributed data. It is only a confirmation of the search selection. This scatter plot view of data can help to visually detect outliers quickly and to determine the grouping pattern of the exams by SSDE, in mgy, represented on the Y-axis. DIR Median Values Obtained Quarterly As well, the scatter plot is a reporting tool that can compare your data to the DIR s last aggregated data Feedback report. Inside the red box on the scatter plot report above, you will notice a dot, a star and a plus sign followed by the RPIDs used as search criteria. On the right side is an equal sign and a numeric value. In this instance, the DIR s Median value for RPIDs 89, 168 and 442 are provided as of the last date we produced the quarterly aggregated Feedback report. You can compare your current RPIDs to the last known DIR aggregate for benchmarking purposes. To save the report: By clicking on the Large Image text (circled in green) the report converts to a document which can be saved to your personal computer or laptop. The enlarged format of the report makes the DIR values much easier to view. Note the three distinctly different lines horizontally through the report are easier to detect (see image below). Page 11

13 Enlarged Scatter Plot Report Can Be Saved To Your Laptop Example 2: Conducting a Scatter Plot Over Time, CTDIvol & RPID Pediatric Search To obtain the scatter plot below use the following search criteria: Data Type: CTDIvol Total for exam Age Type: Pediatric Date Range: left open to search all data submitted Scanner All (or if you want to limit your search to one scanner simply click on the one scanner of interest) Select three RPIDs of interest. Note: When conducting a scatter plot by RPID search you may only select three RPIDs to display. Page 12

14 Example Two: Results of Exam Search Notice that the results of this search yielded nine exams between the ages of 11 and 14 years for the RPID numbers you have preselected. In this case, those RPIDs are RPID34, RPID36 and RPID1804 (displayed in the red box above). As in Example 1, these RPIDs are benchmarked against the DIR s last aggregate report date. The RPID is an abbreviation for RadLex Playbook ID. These IDs are the standardized language that ACR uses for study description names. Every study description must be tagged with an RPID (see Exam Name Mapping Tool User Guide for full instructions) before it can be displayed using this search criterion. Of note, if all of your study description names have not been tagged with an RPID, then the total number of exams per Study Description and RPID search will not be the same. Page 13

15 Example 3: SSDE or Effective Diameter demonstrates the receipt of CTDIvol and Localizers Notice in the scatter plot by SSDE below that there is no DIR dose index value for comparison. The same is true for viewing the scatter plot by DLP. We do not have the DIR aggregate data to provide benchmarking in this reporting tool. Otherwise, all the search functions are the same. The selected criterion in this report has focused on pediatric exams for which we have received a localizer. If we had not received localizers for these exams, there would be no report under the SSDE Data Type option. Note: Head exams will not have SSDE but will have Effective Diameter. This indicates that we have localizers for this exam even if we do not calculate SSDEs for them. Example 3: Scatter Plot with SSDE Max Across Scans, Pediatric Page 14

16 5. BOX PLOT BY SCANNER Standardized DIR Report User Guide Performing a search using Box Plots by Scanner allows the user to compare data from one scanner to the next within the facility or if you have multiple facilities contributing data, you can compare scanners from one location to another. For example, if you have a master-child registration arrangement for all of you facilities, all scanners submitting data from the child locations will populate in the master. Log in to the master facility to view all the scanners in one location. A Box Plot by Scanner search requires the following information: Select Data Type from the Drop down menu for a report with either CTDIvol, DLP or SSDE Select Age Group Select Date range Choose the scanner(s) Choose either RPID or Study Description (but not both) In the picture below, the search fields are shown in pink. Select criterion of interest to you and click Search Box Plot by Scanner Page 15

17 The result of a search example is below. The search criteria used to create this box plot by Scanner report are the following: CTDIvol Max across scans (this unit of measure can be changed by using the drop down arrow) Age Group for Adult and Pediatric Date parameters were left blank to capture all data from the first exam submission until the present Scanners All Study Description All The graph of the box blots can be enlarged by clicking on the Large Image text highlighted in green (see picture below). Box Plot by Scanner Results Page 16

18 The characteristics of the box plot contents are provided beneath the graph and includes the Summary of Stats (above in red box), a list of all exam names, list of all scanners in the graph, and a Age Group by Exam Count summary (not shown here). Should you elect to enlarge the box plot the image can be saved as a document file as shown below. Box Plot by Scanner: Enlarged Image with Tool Bar Note: This search function does not compare scanners across the DIR. It is for a facility s internal use. Page 17

19 6. BOX PLOT BY RPID/STUDY DESCRIPTION This search function is another way to view your data. For example this search tool can quickly display contrast vs. non-contrast exams. In the picture below the following criteria were used: Data Type CTDIvol Max across scans Age Group Pediatric (this is the first example in this user guide of a pediatric report) Date Range left blank Scanner All RPID selected only two exams (CT abdomen pelvis kidney calc with and without contrast) o o RPID390 RPID1075 The resulting report produced two box plots, one for the exam with contrast in box RPID390 and without contrast in box RPID1075. The Summary of Stats below the box plots displays the number of exams contributing to the content of each box (N=40 for the box on the left, N=2 for the box on the right). Note: the blue arrow represents the median value of the DIR. The box plots can be compared to the DIR in this reporting tool. DIR Median Value (Blue Arrow) Page 18

20 Beneath the box plots, the exact dose index is showed for the RPIDs selected. In this example, RPID390 has a median of 5 and the RPID1075 has a median of 1 (see red box in picture below). Box Plot by RPID Results This report can also be enlarged by clicking on Large Image and saved to your personal computer or laptop. Page 19

21 7. SUMMARY COMPARISON Standardized DIR Report User Guide The Summary Comparisons tool generates a summary table that resembles the Executive Summary table in the six month feedback report. The report provides comparisons between your facility s data for any period that you select with corresponding data for the DIR as a whole and for facilities similar to yours (for example, academic or community hospital, metropolitan or rural, in the South or West) from the most recent semi-annual report. Summary Comparison Report Result Page 20

22 Use the export to Excel option for a detailed display of your search. In the Excel document below the most recent dose index, viewed here as CTDIvol Max, have been compared with the DIR as a whole in addition to the other facility characteristics. In this example, the facility is characterized as a multispecialty clinic practicing in a metropolitan location within the Mountain census region of the United States. Excel Facility Characteristic Results Note: unlike the search results for the first four exam reports, Exam Search, Scatter Plot Over Time, Box Plot and Box Plot RPID/Study Instance, this function does provide current comparisons with all DIR facilities in the NRDR Registry. To collect and track this data, you no longer need to wait for the next quarterly or 6 th -month Feedback report. However, the DIR averages and averages for comparable facilities will only be updated every six months. Page 21

23 If you are interested in information on how many other facilities you are being compared to, please consult your most recent semi-annual report, a sample is provided below. The last 6 th -month aggregate DIR Feedback Report Facility Characteristics page is provided for the date range as specified. The columns in red can be added for a total of all facilities contributing data to the DIR during this time frame. Please contact us at nrdr@acr.org with any questions concerning the Standardized DIR Report tool or you may call us at (800) x3535. Page 22