Audit Templates Proforma

Audit Title: CT Colonography Practice

Descriptor: The sensitivity and specificity of CT Colonography (CTC)

Background:

International CT Colonography standards have been agreed and published.(Ref 1).Colonoscopy is currently the gold standard investigation for large bowel pathology. However, approximately 5% of colonoscopies are incomplete and there is a subset of patients who cannot tolerate endoscopic investigation. In these circumstances CTC can provide an alternative investigation. It has also been approved for screening applications. It is therefore essential to have in place mechanisms for ensuring that CTC is performed to an appropriate standard.

The cycle:

THE STANDARD

CTC should demonstrate a greater than 75% sensitivity and greater than 95% specificity for detecting polyps greater than 1cm in size [2,3]. Outside of the context of a clinical trial, and during routine normal working practice within a teaching hospital, a sensitivity of 89% and specificity of 94% has been reported for polyps larger than 5mm in size [4].

National Local

Target

>75% sensitivity and > 95% specificity for detecting polyps greater than 1cm in size [2,3].

LOCAL PRACTICE WAS ASSESSED AS FOLLOWS

The indicator(s)

Data items collected

Number of patients / cases / episodes

SUGGESTIONS FOR CHANGE IF TARGET NOT MET

The Resources Used …

THE DATA was collected by ...

ÿ Computer records ÿ Review of requests ÿ Other (specify)

ÿ Review of images ÿ Ongoing data recording

ÿ Review of reports ÿ Questionnaire

ASSISTANCE

ÿ None ÿ Data analysis ÿ Other (specify)

ÿ Secretarial ÿ Software (off shelf)

ÿ Audit office ÿ Software (customised)

ÿ Medical records ÿ Clinical professionals

TIME to help complete stages 1–3 of the first cycle

R A D I O L O G I S T R A D I O G R A P H E R O T H E R ( s p e c i f y )

Approx _____ hrs per week Approx _____ hrs per week Approx _____ hrs per week

for _____ weeks for _____ weeks for _____ weeks

= total _____ hours = total _____ hours = total _____ hours

COSTS (stages 1–3 of the cycle) apart from radiologists’ / radiographers’ time

ÿ None/minimal ÿ Other (specify) Stages 1–3 of the first cycle

£

ÿ Temporary staff

ÿ Information technology

Results of the Completed Cycle…

Local practice was re-assessed ____________ months after the changes were introduced

Date of re-assessment

Data items collected

Assistance obtained from

£

Costs (stages 5–6) of the re-audit (not including the cost of the changes)

Comparison of findings …

(a) with the standard, shows that ...

(b) with the previous audit findings, shows that ...

(c) indicates that an improvement on the previous audit findings has occurred ÿ Yes ÿ No

A Further Audit will Occur …

in months to start (date)

Useful References …

1. Burling D. on behalf of the International Collaboration for CT Colonography Standards. CT Colonography Standards. Clin Rad 2010;65:474-480
2.Pickhardt PJ, Choi JR, Hwang I et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 2003;349:2191-2200
3.Macari M, Bini EJ, Xue X et al. Colorectal neoplasms: prospective comparison of thin section low dose multi detector row CT colonography and conventional colonoscopy for detection. Radiology 2002;224(2):383-392
4.Grant LA, Griffin N, Shaw AS. Two year audit of computed tomographic colonography in a teaching hospital: are we meeting the standard? Colorectal Dis 2009 Mar 5 [Epub ahead of print].
5.Taylor SA, Laghi A, Lefere P, Halligan S, Stoker J. European society of gastrointestinal and abdominal radiology (ESGAR): Consensus statement on CT Colonography. Eur Radiol 2007;17:575-579

The Audit was carried out by …

Stages 1–4 Stages 5–6

Hospital

Address Telephone No:

Fax No:

A Copy of this form has been …

ÿ placed in the Department’s Audit File

ÿ sent to the Hospital’s Audit Office

ÿ sent to the Clinical Audit Unit at the RCR

Appendix …

Further information (audit design / questionnaire / analysis of results / introduction of change)

is included as follows ...