Lessons learned in setting up a reading centre network for high volume grading in Europe

Abstract

Purpose In 2004, the Verteporfin Photodynamic Therapy (VPDT) study was commissioned in the UK to assess patients with CNV undergoing PDT. A Reading Centre network (NetwORC UK) was established to independently grade 5000+ angiograms per year. Previous to this, there were no independent RCs in Europe capable of grading this volume. Methods Three geographically distinct centres (Belfast, Liverpool and London) form NetwORC UK with a management facility (CARF) coordinating the administrative and technical aspects. A custom software platform was developed to manage the import, transmission and grading of images, collection of data between the three RCs, and ensure communication across separate IT networks. Quality assurance and concordance ensure grading is consistent across NetwORC UK. Results Between October 2005 and October 2007, 12612 angiograms were graded and 6833 were baseline angiograms. The grading of angiograms is ongoing in NetwORC UK and will continue until the study ceases. Conclusion A network structure has enabled grading of a large volume of images from the VPDT study. Regular training and concordance exercises have contributed to the success of this service. The authors recommend that the administration and management is separate from grading ensuring grading staff are dedicated to grading tasks. Therefore technical queries and software can be managed in one location, importing and exporting data can be centralised, vacation and sickness cover is easier to maintain, and unique training is offered by pooling staff from different locations. Regular monitoring of IT systems ensures data has integrity and dedicated IT personnel are essential. Future studies of this size will now be possible in Europe using NetwORC UK.