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- TABLE 1
Characteristics of Nuclear Cardiology Laboratories Applying for IAC Nuclear/PET Accreditation, 2011–2014
Characteristic All laboratories (n = 1,913) Accreditation granted (n = 779) Accreditation delayed (n = 1,134) P Facility characteristics Region (n) 0.002 Northeast 478 (25.0%) 203 (26.1%) 275 (24.3%) Midwest 329 (17.2%) 160 (20.5%) 169 (14.9%) South 869 (45.4%) 318 (40.8%) 551 (48.6%) West 237 (12.4%) 98 (12.6%) 139 (12.3%) Hospital-based laboratory (n) 232 (12.1%) 98 (12.6%) 134 (11.8%) 0.62 Number of sites (mean) 1.72 (SD, 3.21) 1.79 (SD, 3.68) 1.68 (SD, 2.84) 0.21 General nuclear medicine or PET (n) 175 (9.1%) 60 (7.7%) 115 (14.8%) 0.07 MPI volume (mean) 1,457.58 (SD, 1,638.33) 1,549.5 (SD, 1,769.28) 1,394.5 (SD, 1,539.58) 0.06 Number of application cycles (mean) 2.82 (SD, 1.01) 2.87 (SD, 1.02) 2.78 (SD, 1.01) 0.12 Consultant used (n) 318 (16.6%) 166 (21.3%) 152 (13.4%) <0.001 - TABLE 2
Characteristics of Nuclear Cardiology Laboratory Staffs (Physician and Technologist) Applying for IAC Nuclear/PET Accreditation, 2011–2014
Characteristic All laboratories (n = 1,913) Accreditation granted (n = 779) Accreditation delayed (n = 1,134) P Physician characteristics Medical director years of experience (mean) 17.47 (SD, 8.34) 17.34 (SD, 8.36) 17.55 (SD, 8.32) 0.67 Medical director annual number of studies interpreted (mean) 804.20 (SD, 1,273.8) 746.46 (SD, 1,273.48) 843.87 (SD, 1,273.07) 0.06 Medical director with CBNC (n) 1,107 (57.9%) 491 (63.0%) 616 (54.3%) <0.001 Medical director who is cardiologist (n) 1,330 (69.5%) 564 (72.4%) 766 (67.5%) 0.02 Medical director compliant with CME (n) 1,432 (74.9%) 664 (85.2%) 768 (67.7%) <0.001 MPI volume per medical director (mean) 475.79 (SD, 409.07) 468.94 (SD, 416.16) 485.75 (SD, 398.57) 0.92 Number of medical staff (mean) 3.18 (SD, 5.04) 3.39 (SD, 5.49) 3.03 (SD, 4.71) 0.05 Number of CBNC staff (mean) 1.37 (SD, 2.50) 1.58 (SD, 2.85) 1.22 (SD, 2.22) <0.001 Number of medical staff CME-compliant (mean) 2.36 (SD, 4.10) 2.83 (SD, 4.73) 2.05 (SD, 3.58) <0.001 Technologist characteristics Technical director years of experience (mean) 19.21 (SD, 10.12) 19.95 (SD, 10.20) 18.71 (SD, 10.03) 0.35 Number of technologists (mean) 2.55 (SD, 2.85) 2.64 (SD, 2.83) 2.49 (SD, 2.87) 0.43 Number of technical staff (mean) 1.55 (SD, 2.85) 1.64 (SD, 2.84) 1.49 (SD, 2.87) 0.43 Technical director compliant with CME (n) 1,538 (80.4%) 702 (90.1%) 836 (73.7%) <0.001 Number of technical staff CE-compliant (mean) 1.26 (SD, 2.45) 1.43 (SD, 2.57) 1.14 (SD, 2.36) 0.01 Technical director with PET or NCT plus CNMT or RT(N) (n) 166 (8.7%) 82 (10.5%) 84 (7.40%) 0.02 Technical director with (RT[R], RT[CT], or RT[MR]) plus CNMT or RT(N) (n) 284 (14.8%) 117 (15.0%) 167 (14.7%) 0.86 - TABLE 3
Impact of Laboratory Characteristics and Staff Training and Credentials on MPI Accreditation Decisions
Characteristic Adjusted odds ratio Number of sites 1.01 (0.97–1.05) Annual laboratory volume per 1,000 MPI studies 1.06 (0.96–1.18) Application cycle (per subsequent cycle) 1.00 (0.91–1.11) Consultant assistance with application 1.94 (1.49–2.53) Hospital facility 1.08 (0.75–1.57) Doing general nuclear medicine or PET oncology/neurology 0.89 (0.58–1.37) Medical director with CBNC status 1.28 (1.03–1.58) Cardiovascular pathway of medical director 1.03 (0.82–1.29) Medical director compliant with CME 1.97 (1.53–2.54) Volume of studies interpreted by medical director, quartiles 0–300 Referent 301–500 1.21 (0.92–1.60) 501–900 1.03 (0.78–1.36) 901+ 0.75 (0.55–1.03) Number of medical staff 0.82 (0.75–0.89) At least 50% of medical staff with CBNC 1.06 (0.85–1.31) Number of medical staff compliant with CE 1.28 (1.16–1.42) Technical director with NCT or PET vs. CNMT or RT(N) 1.49 (1.06–2.10) Technical director compliant with CE 2.48 (1.86–3.31) Number of technical staff 0.91 (0.80–1.04) Number of technical staff compliant with CE 1.12 (0.97–1.29) 95% confidence intervals are in parentheses.
- TABLE 4
Impact of Laboratory Characteristics and Staff Training on IAC Nuclear/PET Review Deficiencies in Protocols and Reporting
Characteristic Adjusted odds ratio for protocol deficiencies Adjusted odds ratio for reporting deficiencies Number of sites 1.06 (0.96–1.19) 1.08 (1.02–1.13) Annual laboratory volume per 1,000 MPI studies 0.93 (0.84–1.02) 0.95 (0.86–1.04) Application cycle (per subsequent cycle) 1.07 (0.96–1.19) 1.00 (0.91–1.10) Consultant assistance with application 0.55 (0.41–0.73) 0.63 (0.48–0.81) Hospital facility 1.24 (0.85–1.82) 0.78 (0.54–1.13) Doing general nuclear medicine or PET oncology/neurology 1.70 (1.12–2.56) 0.99 (0.66–1.49) Medical director with CBNC status 0.88 (0.71–1.09) 0.78 (0.63–0.95) Cardiovascular pathway of medical director 0.99 (0.79–1.24) 0.82 (0.66–1.02) Medical director compliant with CME 0.55 (0.44–0.69) 0.64 (0.51–0.80) Volume of studies interpreted by medical director, quartiles 0–300 Referent Referent 301–500 0.87 (0.65–1.16) 0.91 (0.70–1.20) 501–900 0.98 (0.74–1.30) 0.93 (0.71–1.22) 901+ 1.51 (1.12–2.03) 1.09 (0.81–1.45) Number of medical staff 1.16 (1.08–1.24) 1.04 (0.97–1.11) At least 50% of medical staff with CBNC 0.85 (0.68–1.06) 0.90 (0.73–1.11) Number of medical staff compliant with CME 0.84 (0.77–0.91) 0.94 (0.87–1.02) Technical director with NCT or PET vs. CNMT or RT(N) 0.79 (0.55–1.13) 0.67 (0.47–0.95) Technical director compliant with CE 0.56 (0.44–0.72) 0.53 (0.41–0.67) Number of technical staff 0.92 (0.81–1.04) 1.00 (0.90–1.11) Number of technical staff compliant with CE 1.06 (0.92–1.21) 0.98 (0.87–1.11) 95% confidence intervals are in parentheses.
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