Results Summary and Professional Abstract
Related PCORI Dissemination and Implementation Project
|Article Highlight: Clinicians use computerized tomography (CT) scans to pinpoint a range of health problems, including infections and cancers. The scans expose patients to radiation called a CT dose, which slightly increases the patient’s risk of cancer. This study analyzed CT doses from more than 2 million CT scans across seven countries to learn if the doses varied across hospitals and countries. Doses varied modestly by hospital, but across countries, there was wide variation in radiation levels. As reported in The BMJ, these findings suggest that there is a need to implement strategies that can be used to modify and lower hospital radiation dose levels.|
|This project's final research report is expected to be available by April 2020.|
Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.
The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments.
Peer reviewers commented and the researchers made changes or provided responses. Those comments and responses included the following:
- The reviewers had extensive criticisms of the background section, saying that it used out-of-date references and seemed overly biased against the risk of radiation from computed tomography (CT) imaging. They asked that the section be trimmed. The researchers shortened and simplified the background section. They felt that it was important to point out, however, that there is no meaningful controversy in the scientific literature about the carcinogenic risk from the use of ionizing radiation in medical imaging.
- The reviewers suggested that the study could have more productive if focused on different topics, such as addressing the overuse of CT rather than the radiation exposure per scan. The researchers stated that they could not address these criticisms as the study was complete.
- Other topics, they said, are outside the scope of their report and their response.
- The reviewers suggested that radiation doses might have been overestimated or underestimated for patients of different sizes. The researchers replied that they reported effective dose, not organ dose, and that they accounted for patient size to reflect dose needs. They also said that authors of the study included medical physicists, including a past president of the American Association of Physicists in Medicine, who helped define how all measurements were calculated.
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