Abstract
Long-term clinical trials using bone mineral density (BMD) measurements are now commonplace. It is important to maintain a high standard of quality control. In this study two methods of monitoring quality control measurements of dual-energy X-ray absorptio-metry (DXA) equipment have been compared using receiver operating curve (ROC) analysis: Shewhart multi-rule charts and Cusum charts. Computer-generated faults within daily spine phantom measurements were used. The Charts were then applied to 3 years of quality control data from one machine and the results related to hardware faults, random events and changes in the underlying BMD measurement. In the ROC analysis the Shewhart multi-rule chart performed as well or better than the cusum chart, but the stringency of the rules must be tightened to obtain optimal performance.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Orwoll ES, Oviatt SK, Biddle JA. Precision of dual energy X-ray absorptiometry: development of quality control rules and their application to longitudinal studies. Osteoporosis Int 1993;8:693–9.
Glüer C-C, Faulkner KG, Estilo MJ, Engelke K, Rosin J, Genant HK. Quality assurance for bone densitometry research studies: concept and impact. Osteoporos Int 1993;3:227–35.
BS5703. Guide to data analysis and quality control using Cusum techniques. London: British Standards Institution, 1980, 1981.
Pearson D, Kapasi T. A comparison of two methods of measuring gamma camera uniformity. Nucl Med Commun 1988;9:69–73.
Knight AC, Williams ED. An evaluation of cusum analysis and control charts applied to quantitative gamma-camera uniformity parameters for automated quality control. Eur J Nucl Med 1992;19:125–30
Pearson D, Cawte SA. The use of control charts in DXA quality control [abstract]. Proceedings of the 1996 World Congress on Osteoporosis. Osteoporos Int 1996; 6(Supl 1):199.
Garland SW, Lees B, Stevenson JC. A comparison of multirule Shewhart and Cusum charts for DXA quality control [abstract]. Current research in osteoporosis and bone mineral measurement IV. 1996:55–6.
Westgard JO, Barry PL, Hunt MR, Groth T. A multi-rule Shewhart chart for quality control in clinical chemistry. Clin Chem 1981;27:493–501.
Orwoll ES, Oviatt SK and the Nafarelin/Bone study group. Longitudinal precision of dual energy X-ray absorptiometry in a multicentre study. J Bone Miner Res 1991;6:191–7.
Wahner HW, Looker A, Dunn WL, Walters LC, Hauser MF, Novak C. Quality control of bone densitometry in a national health survey (NHANES III) using three mobile examination centres. J Bone Miner Res 1994;9:951–60.
Faulkner KG, McClung MR. Quality control of DXA instruments in multicenter trials. Osteoporos Int 1995;5:218–27
Metz CE. ROC methodology in radiological imaging. Invest Radiol 1986;21:720–33.
Kalender WA, Felsenberg D, Genant HK, Fisher M, Dequeker J, Reeve J. The European spine Phantom: a tool for standardization and quality control in spinal bone mineral measurement by DXA and QCT. Eur J Radiol 1995;20:83–92.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pearson, D., Cawte, S.A. Long-term quality control of DXA: A comparison of shewhart rules and cusum charts. Osteoporosis Int 7, 338–343 (1997). https://doi.org/10.1007/BF01623774
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01623774