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A Holistic Approach to Purchasing Decisions

There are many factors that should be weighed into purchasing decisions for new medical imaging equipment, first and foremost the needs of the patient. However, these important decisions might be made on an ad hoc basis without accounting for certain key quality requirements. In purchasing a fleet of mobile radiography units, a new approach akin to the “Consumer Report” format which engages not only clinical and purchasing staff but physicists and technologists is getting good reviews at Duke where it has been demonstrated.

“Often, physicists perform testing once machines have been purchased and thus are an untapped resource of knowledge and expertise in making data-driven purchase decisions,” says Ehsan Samei, chief imaging physicist at Duke University. Four vendors were first asked to demonstrate their units. A survey was then administered listing features most affecting technologists ability to acquire a quality image in practice. Technologists were asked to rate the overall performance of the unit with regard to each of these features on a scale of 0 (poor) to 100 (excellent). This was followed by a blind study of radiologists’ perception of image quality on 60 randomly selected clinical bedside chest images. Each image was rated in terms of overall quality, mediastinum noise, rib contrast, lung density, and lung detail.

Assessments
Technologistsí assessments of mobile x-ray units.

Using a “Consumer Report” format, these results were combined to provide a comprehensive assessment of equipment options including data gathered from technologists on desirable features, radiologists on image quality, vendor specifications made into uniform comparisons, and physicists’ measurements. The outcome was a report that helped the clinical leadership to make an informed decision. “This type of coordinated, comprehensive approach engages physicists in the evaluation process and results in evidence-based decisions regarding equipment purchase that will help us deliver the best and most effective patient care with confidence and accountability,” says Samei.

Sample Response
Sample response form the image quality study evaluation by radiologists.