PRELIMINARY ASSESSMENT OF STRUCTURE AND COLLECTIVE DOSE FROM CT EXAMINATIONS RELATED TO COVID-19 DIAGNOSTICS IN THE RUSSIAN FEDERATION IN MARCH - JUNE 2020

  1. A.V. Vodovatov
  2. I.K. Romanovich
  3. O.A. Istorik
  4. L.A. Eremina
  5. S.P. Morozov
  6. S.A. Ryzhov
  7. G.V. Berkovich
  8. I.G. Kamyshanskaya
  9. G.E. Trufanov
  10. L.A. Chipiga
  11. P. S. Druzhinina
  12. A.M. Biblin
  13. R.R. Akhmatdinov
  14. I.V. Basek
  15. A.A. Karatetskiy
  16. D. V. Merkulov
  17. Yu.S. Ispravnikova
  18. V.V. Pritz
  19. N.S. Polishchuk
  20. A.N Mukhortova
  21. V.G. Pyzyrev

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Abstract

The use of computed tomography (CT) for the diagnostics of COVID-19 in the Russian Federation led to significant changes in the structure of X-ray diagnostics and levels of medical exposure of the patients. This study was aimed at the preliminary operative assessment of changes in the structure and collective dose from CT examinations in several representative hospitals, regions and on the level of the Russian Federation. The results of the study indicate that during the transformation of hospitals from general medical practice into dedicated COVID-19 facilities, the number of CT examinations increased up to 30%; the collective dose from CT exams increased up to a factor of 1.5. During a partial transformation of a medical facility into the hospital with separate COVID-19 departments, the increase in the number of CT examinations in the facility was more significant (up to a factor of 2 or more). These numbers correspond to 1.5 - 2.5 chest CT examinations (from 1 to 6) per patient admitted to hospital with COVID-19 diagnosis; and 1.2 chest CT examinations per patient in outpatient facilities, including a mandatory CT scan for the staging of COVID-19. The collective dose from CT examinations in the Russian Federation for March-June period of 2020 increased by the factor of 2 (from 16k man-Sv to 32k man-Sv); the collective dose of COVID-19 patients was about 12k man-Sv. For a more detailed and reliable assessment of the dynamics of changes in the structure of diagnostic radiology and levels of radiation exposure of patients in the Russian Federation, data collection in the regions of the Russian Federation and individual medical facilities will continue.

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  1. ScreenIT

    SciScore for 10.1101/2020.08.25.20181396: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variable–estimation of the collective dose from CT examinations according to the equation (4):

    where: Ecoll - the collective dose from CT exams, man - Sv; Npat - the number of patients who underwent the selected CT exams, people; Etype - the average individual effective dose from CT exams of the selected anatomical area in the selected region, mSv. – assessment of the risk of radiation-induced malignancies and hereditary diseases from CT examinations per 1 million people in the Russian Federation according to the equation (5):

    where: R - the number of possible cases of radiation-induced malignant neoplasms and hereditary diseases from CT exams per 1 million people in the Russian Federation, cases per 1 million people; Ecoll - collective dose from CT exams, man-Sv; K – the linear coefficient of radiation risk - 5,7 × 10 -2 Sv -13; n - the Russian population (146 700 000 people).

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.08.25.20181396v1 on medRxiv