Study suggests differences in CT readings at oncology centers vs. general hospitals may impact RVUs

May 05, 2003

Preliminary results of a recent study suggest that CT readings at oncology centers are more time-consuming, complex, and have many more findings than readings at general hospitals, says Eric vanSonnenberg, MD, chief of radiology at Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, and an author of the study.

Dr. vanSonnenberg says the study focuses on the complexities involved in CT readings at oncology centers vs. general hospitals and how they affect relative value unit assessments (RVUs), which measure productivity of physicians.

To determine how radiologists were using their time, Dr. vanSonnenberg and his colleagues compared the CT reports of 100 patients from an oncology center to CT reports of 100 patients from an affiliated general hospital. Reports were compared for type and number of associated studies, including chest, abdomen, and/or pelvis, length of report, number of characters, presence/absence of comparison films, number of tumor measurements obtained, and number of overall negative studies.

The average number of words in a CT report for the same examination at an oncology center was 338 compared with 276 at a general hospital. Similarly, the average number of characters in a report at an oncology center was 1,807 compared with 1,541 at a general hospital.

Prior scans were obtained and directly compared with the current scans in more than 90% of oncology center cases, compared with 50% at a general hospital. Likewise, measurements of tumor size were made in three-quarters of oncology center cases vs. 20% of general hospital cases.

CT scans in general hospitals are usually intended to target specific problem areas, Dr. vanSonnenberg says. "Exams at oncology centers are not just about a specific diagnosis or anatomic site; cancer can affect so many areas of the body with a host of potential complications. CT examinations in oncology centers tend to include a greater number of scans, from the chest through the pelvis, and are more reliant on prior scans for comparison."

Because the CT scans are more complex, it takes radiologists more time to read them, says Dr. vanSonnenberg. "CT scans read at general hospitals, for example, can take 3-5 minutes, while those at a cancer center can take upwards of 10-15 minutes," he says. Interruptions for consultations can also be more numerous at cancer centers as well.

All of these factors must be considered when reviewing radiologists' productivity, Dr. vanSonnenberg says.

The study will be presented May 5, during the American Roentgen Ray Society Annual Meeting in San Diego.
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Danica Laub, 703-858-4332
Keri Sperry, 703-858-4306
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American College of Radiology

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