[Current questions of quality assurance in diagnostic radiology in the light of a visit to England]
PORUBSZKY Tamás, GICZI Ferenc, BALLAY László, PELLET Sándor
FEBRUARY 20, 2002
Hungarian Radiology - 2002;76(01)
PORUBSZKY Tamás, GICZI Ferenc, BALLAY László, PELLET Sándor
FEBRUARY 20, 2002
Hungarian Radiology - 2002;76(01)
[Physical-technical aspects of quality assurance in diagnostic radiology, because of its dependence on technology are of an extraordinary importance. The intention of Hungary to join EU makes at least the decrease of our lag in this respect unavoidable. Ministerial order 31/2001 (X. 3.) EüM which already came into force requires quality assurance in diagnostic radiology explicitly. This paper starts with definition of basic concepts, then outlooks shortly the history and present international situation of quality assurance in diagnostic radiology. We review preliminaries and the present situation in Hungary, including results of the National Patient Dose Assessment Programme till now. We think that the most efficient help to the initial steps of quality assurance in diagnostic radiology in Hungary may be the appropriate adaptation of experiences of the leading countries. Therefore we review experiences of one of the authors gained during visiting three medical physics centres in England in details. The following topics are discussed: legal requirements, types and levels of measurements, organizational problems, practical evaluation of measurements (including criteria of discarding equipment), patient dosimetry, personal dosimetry, mammography research, instrumentation of the radiology departments, calibration of measuring devices, questions of the so-called type testing and radiation protection training of workers.]
Hungarian Radiology
Hungarian Radiology
Hungarian Radiology
Hungarian Radiology
Hungarian Radiology
[Interventional radiology is a relatively new and very rapidly developing cost-effective branch of radiology. Its aim to help or to replace surgical procedures and interventions in many cases are life saving, which are performed by imaging modality control (most commonly angiography or fluoroscopy). During interventional radiological procedures the exposure of staff and patients is usually higher, than in conventional radiography or fluoroscopy. Deterministic effects may also occur. The dosimetry can be carried out by film dosimetry, thermoluminescent dosimetry, DAP meters, semiconductor detectors and personal electronic dosimeter. The basis of reduction of radiation exposure is the radiation protection training. An important rule is that reduction of patient exposure is connected with reduction of staff exposure. With the use of appropriate tools and training the most injuries are avoidable.]
Hypertension and nephrology
[A dialysis provider’s core activities include providing dialysis care with excellent quality, ensuring a low variability across the clinic network and ensuring strong focus on patient safety. In this article, we summarize the pertinent components of the quality assurance and safety program of the Diaverum Renal Services Group. Concerning medical performance, the key components of a successful quality program are setting treatment targets; implementing evidence- based guidelines and clinical protocols and revising targets, guidelines and clinical protocols based on sound scientific data. Consistently, regularly, prospectively and accurately collecting data from all clinics in the network; processing collected data to provide feedback to clinics in a timely manner. The key activities for ensuring patient safety include a standardized approach to education, i.e. a uniform education program including control of theoretical knowledge and clinical competencies; implementation of clinical policies and procedures in the organization in order to reduce variability and potential defects in clinic practice. We point out the importance of auditing clinical practice on a regular basis. By applying a standardized and systematic continuous quality improvement approach throughout the entire organization, it has been possible for Diaverum to progressively improve medical performance and ensure patient safety]
Clinical Neuroscience
[The history of rehabilitation of people with disabilities as a consequence of neurological conditions goes back to more than four decades in Hungary. The authors describe its history, how this service is organized nowadays, questions of specialization, scientific activity and quality improvement. They emphasise: any form of neurorehabilitation service (special neurorehabilitation department or programme of a multiprofile rehabilitation unit) must meet the same criteria. Quality assurance will be provided by a new accreditation system.]
Hungarian Radiology
[The use of adequate imaging protocol reduces morbidity and mortality in emergency cases of pregnant women. The least harmful, but sufficiently informative imaging method should be chosen that provides us with the diagnosis in the shortest delay. Although the reduction of harmful effects is important, life threatening complications can be avoided by an indicated and well effectuated imaging method using ionizing radiation.]
Clinical Oncology
[Today the information could be the basis of further development by collecting, saving, structuring and analyzing them. Inside the living organism and inside viruses the biochemical storage system was evolved. The linear coding inside macromolecular structures could create and store a series of building block combinations along the chain structure. Those chemical structures are the so called information coding macromolecules, for example, the polypeptides and nucleic acids. Analysis of the genetically coded functionalities of tumor cells has a great impact in the oncological setting. The connected functions of inherited or acquired alterations inside the tumor cell clones are the main contributors of tumor evolution and surviving, although provide a way to target possible mechanism and touch points. Today the oncodiagnostic use of next generation sequencing technology focus on tumor evolution and tumor surviving connected gene set analysis. This kind of gene panel analysis connected to NGS technology is enough enforced - enforced enough - to reach the diagnostic level, but one still need to take care about the quality and standardization to meet the IVD conditions.]
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Clinical Neuroscience
Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease3.
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Clinical Neuroscience
Cases of inborn errors of metabolism diagnosed in children with autism2.
Clinical Neuroscience
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Clinical Neuroscience
Retinal morphological changes during the two years of follow-up in Parkinson’s disease4.
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