Report Purpose


The Dose Index Registry (DIR) Digital Radiography (DR) pilot group developed a standardized dose index report that enables users to analyze their digital radiography dose data. Report filters help users obtain an overview of digital radiography equipment performance and delve into the details. While the DIR DR is in the pilot phase, sites currently sending DIR DR data can observe how they are displayed and are welcome to provide report feedback via the report Feedback link in the upper left corner of the report. The report will continue to be updated by the DIR DR pilot group. 


How to Access

From the DIR directory page in the NRDR portal, select DR Standardized Dose Index Reports. The About this Report tab provides insight into the reports’ measures and filter use. 


Help Features

The report has several features to help users navigate the various report filters and functions and understand the data presented. 

  • The About this Report tab provides a description of each report tab and information about the filters and filter selection.

  • Several report tabs include a Help link in the left-most corner that displays a detailed informational report overlay about report navigation

  • The blue information dot provides simple navigational tips and background information about how to use the report

  • Read about this report links to this Knowledge Base article

  • The Feedback link enables users to make suggestions about new report features and provide general input.

Report Tab Overview

Exam Search 

Get started by selecting a Corporate Account, a corresponding Facility, or Facilities, and a timeframe of interest. You can display the report by exam, events, or both.  You can also filter the report by study type or by specific digital radiography equipment/station. The sample screenshot below shows a listing of both the exams and events for X-ray elbow exams (three or more views) performed over two months across all digital radiography stations for adult (over 18 years) patients. The individual exam and event data appear on the left side of the table.

Using the scrollbar at the bottom of the page, scroll to the right to view the dose indices table for each exam event including Deviation Index (DI) Exposure Index (EI), and Target Exposure Index (TEI).



Scatterplot Over Time Report

This feature helps you identify unusual patterns or outliers for DIR DR dose indices. Use the report filters and parameters, e.g., Measure, Study Type and Station, to refine the data in the scatterplot. You also can hone in on facility performance by the specific station. Hovering over a measure dot in the scatterplot provides exam details. The following screenshot illustrates several components of the scatterplot.

Boxplot by Station

The filters allow you to assess dose index data between stations in a box-and-whisker format. In the example below, hovering the cursor over the shaded box area displays the Exposure Index for elbow X-ray exams over 30 days for Station 4 with the black horizontal “whisker” lines denoting the cutoff for statistical outliers. Hovering over a single measure dot shows procedure details.

Boxplot by Procedure

The filters allow you to analyze dose indices by a procedure in a box-and-whisker format. In the example below, hovering the cursor over the shaded “box” area displays the Exposure Index quartile data for left ankle procedures over 30 days with the black horizontal “whisker” lines denoting the cutoff for statistical outliers. Hovering over a single measure dot shows procedure details.


Summary Statistics

This report displays select statistics for Exposure Index (EI), Target Exposure Index (Elt) and Deviation Index (DI) measures by procedures using event-level data.  When the mean DI is within the range of -1.0 to +1.0 then the Initial Control Limits column is displayed. When the mean DI is outside the range, the row is highlighted in gray.

Index Comparisons

The Index Comparison report displays Exposure Index (EI), Target Exposure Index (EIT), Deviation Index (DI), and Kerma Area Product (KAP) dose indices for one or more facilities and selected exams.  Providing a side-by-side comparison of the EI and EIT distributions helps users understand the corresponding DI distribution.  By reviewing the KAP distribution simultaneously with EI EIT and DI, users may begin to correlate dose performance with image quality.

For studies mapped to ACR Common IDs, registry statistics are also available for comparison to facility data. Viewing how facility EI and EIT distributions compare to corresponding registry statistics can serve as a starting point for identifying, for example, exposure technique problems. The example below displays data for unilateral knee X-rays for three facilities for a one-week period. Hovering over a dot displays exam details. The registry statistics are shown by a solid red line (median) and dotted red line (interquartile range).