The goal of Work Package 4 is to develop common methodology and tools for carrying out the co-ordinated national/regional audits of justification of CT examinations. The common methodology will take into account the lessons learned from Work Package 2 as well as any guidance in the subject area issued by the relevant European regulatory and professional societies and networks.
The audit methodology will cover key elements of the referral and justification process including the assignment of responsibilities, the referrals vetting process, existence and use of referral guidelines, communication between the referrer and the radiological practitioner, mechanisms and evidence for resolving conflicting opinions, etc. Furthermore, the methodology will define the procedures for sampling, auditing the justification outcomes and determination of the rates of appropriateness for the different types of CT examinations against pre-defined audit standards. The methodology will foresee mechanisms to identify and analyse the sampling method that should be scientifically sound and reproducible, the differences between adult and paediatric populations, public and private institutions, general practitioners and clinical specialist referrals, etc.
The final audit methodology and tools used for the EU-JUST-CT pilot audits can be viewed here. The Audit form, as used in the tutorial below, can be downloaded here.
The imaging referral guidelines of the ESR embedded in the ESR iGuide have been chosen for use as a standard for the audits. Auditors were invited to attend tutorial sessions introducing them to the process for using the ESR iGuide. A recording of one of the tutorials is provided below.
Lead: A. Karoussou-Schreiner
Co-Lead: B. Brkljačić
Contributors: J. Sosna, R. Bly, S. Ebdon-Jackson, F. Demuth, S. Bhumbra, Project Office, A. Bouëtté, D. Pfeffermann, Steering Group
Task 4.1. Develop preliminary draft audit methodology and tools
Task 4.2. Stakeholder consultation on draft audit methodology and tools
Task 4.3. Update draft audit methodology and audit tools based on stakeholder feedback for inclusion in second progress report