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The FDA Enhancing Quality Using the Inspection Program (EQUIP) Breast Imaging Quality Initiative. 5-Year Clinical

Jeffrey R Hawley¹, Cynthia Ha¹, Linda Cai¹

¹Department of Radiology, Ohio State University Wexner Medical Center, Columbus, OH,USA.

Journal of Breast Imaging

|June 29, 2024

Summary

The Enhancing Quality Using the Inspection Program (EQUIP) identified few deficiencies in quality control and assurance processes. EQUIP implementation showed potential for supplemental cancer detection, suggesting policy evaluation for optimized resource use.

Keywords:

EQUIP MQSA quality assurance quality control screening mammography

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Area of Science:

Radiology
Medical Imaging
Quality Improvement

Background:

Quality control (QC) and quality assurance (QA) are critical in medical imaging.
The Enhancing Quality Using the Inspection Program (EQUIP) is a program designed to improve these processes.
Academic medical centers require robust systems for evaluating imaging quality.

Purpose of the Study:

To evaluate the impact of the EQUIP program on QC and QA at an academic medical center.
To assess the effectiveness of EQUIP in identifying deficiencies in technologist performance and mammography unit operations.
To determine the supplemental cancer detection rate associated with the EQUIP review process.

Main Methods:

Utilized EQUIP audit logs for technologist image quality review and mammography unit QA/QC.
Lead Interpreting Physicians (LIPs) reviewed screening mammograms for quality and interpretive accuracy.
LIPs also reviewed mammography unit QA/QC logs, investigating identified deficiencies.

Main Results:

A small percentage (2.8%) of screening mammograms underwent EQUIP review, with very few (0.08%) found technically inadequate.
Significant interpretive differences were noted, leading to biopsies and the detection of 7 previously undetected malignancies.
Most mammography unit QA/QC deficiencies were due to human documentation errors (93.4%).

Conclusions:

The EQUIP review identified minimal deficiencies in technologist quality and mammography unit QA/QC.
Institutions should evaluate and adapt EQUIP policies to maximize resource utilization and quality improvement.
Supplemental cancer detection was an observed benefit, potentially due to the double-reading aspect of the review.