KCARE, A Short History
As the range and complexity of diagnostic X-ray equipment grows, the task of selecting a system to meet the needs of both patient and staff becomes increasingly difficult. In the United Kingdom the Department of Health (DoH) has addressed this problem by establishing a number of centres within the National Health Service (NHS) to provide objective and independent technical and clinical assessment of particular types of medical equipment.
KCARE, the Kings Centre for the Assessment of Radiological Equipment is one of these centres and began work in January 1979, with the official opening in November 1979.
At that time, the majority of diagnostic X-ray equipment was purchased centrally via the DoH Scientific and Technical Branch (STB). Unfortunately, a number of the systems that were purchased proved unsatisfactory or unreliable in subsequent use. The DoH Radiological Equipment Sub-Committee put forward the idea of an evaluation centre which would allow X-ray systems to be fully tested, both technically and clinically, before purchase.
As the range and complexity of diagnostic X-ray equipment grows, the task of selecting a system to meet the needs of both patient and staff becomes increasingly difficult. In the United Kingdom the Department of Health (DoH) has addressed this problem by establishing a number of centres within the National Health Service (NHS) to provide objective and independent technical and clinical assessment of particular types of medical equipment.
Evaluation in a clinical context can be difficult and it was decided to build an X-ray department especially designed and dedicated to undertake the assessment of diagnostic X-ray equipment. King’s College Hospital was selected as a suitable site and a two-room radiological assessment unit was constructed above the X-ray Department.
A short time after KCARE was set up, the purchase of diagnostic X-ray equipment was devolved to the NHS regions but the concept of equipment evaluation was showing its value and has continued to the current time.
The number of new products appearing each year is so large that with ‘in-house’ evaluation it was impossible for KCARE to assess every new piece of equipment. Therefore, in the late 1990s, it was decided to move towards ‘out’ evaluation of equipment at suitable hospital sites or manufacturer’s premises. Smaller pieces of equipment, such as mobile X-ray systems, can be tested in KCARE’s X-ray laboratory. This approach has allowed a far wider range of equipment to be covered.
The Centre’s staff includes five physicists and two radiographers, each with appropriate qualifications and experience to assess radiological equipment. Additionally, the administrative staff comprises the centre director and office manager.
The objective of the Centre is to provide purchasers with accurate and comprehensive technological and clinical information about the equipment, not generally available from other sources.
Technical information and measurements are obtained by the physicists using both standard and specially developed techniques and can be used either as comparative or baseline data.
Clinical information is obtained by radiography of anthropomorphic phantoms plus observation of the equipment in use in a clinical environment and completion of questionnaires by the clinical staff using the equipment.
KCARE has also worked closely with the National Health Service Breast Screening Programme (NHSBSP) since its inception in 1988 and all mammography imaging equipment offered to the NHSBSP is scheduled for evaluation.
The
assessments are published as blue cover reports are either in single
product or comparative format. The equipment supplier is shown the report
in draft form and invited to comment, these comments are included in
the published version. Additionally, KCARE prepare and regularly update
comparative specifications of various categories of X-ray imaging equipment.
The reports are distributed free to interested parties within the NHS
and are available for purchase by others.