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The Nationwide Evaluation of X-ray Trends (NEXT) program is a partnership between the Conference of Radiation Control Program Directors, Inc. (CRCPD) and the Food and Drug Administration (FDA) Center for Devices and Radiological Health (CDRH), with financial support from the American College of Radiology (ACR) since 1998, to characterize the radiation doses patients receive during diagnostic x-ray examinations.

The NEXT survey program selects a particular radiological examination for study and captures radiation exposure data from a nationally representative sample of U.S. clinical facilities. Volunteer state radiation control personnel conduct the surveys using reference phantoms most of which are clinically validated to represent the radiation attenuation presented by an average-size patient. Surveys are repeated periodically to track trends as technology and clinical practices change.

The NEXT trifold brochures contain a summary of significant technical findings of a particular survey, and are intended to provide a brief snapshot of the state-of-practice to both the radiation protection specialist and to the practicing radiological community.   Clinical facilities can compare findings at their site or patient exposure and clinical quality indicators with statistical findings representing the U.S. practicing community. The companion brochure ' Thirty Years of NEXT' briefly summarizes selected technical parameters of most of the past surveys.

NEXT protocols provide procedures for capturing technical data associated with the practice of the surveyed diagnostic x-ray procedure, including patient skin-entrance air kerma, image quality, clinical technique factors, quality of film processing, and general QA/QC procedures.  NEXT protocols must be used in conjunction with the associated NEXT phantom in order to compare acquired exposure data with existing NEXT survey results.

Currently, NEXT is undertaking a chiropractic survey. A survey form has been developed, and the CRCPD committee on NEXT (H-4) conducted a webinar training for the form.  You can view the webinar here

Our latest NEXT Publication, the 2019 Dental Trifold, may be downloaded here.


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Nationwide Evaluation of X-Ray Trends
Item Name Posted By Date Posted
2003NEXT_FluoroscopySurvey PDF (691.59 KB)  more ] Administration 11/21/2017
2005CT_FacilityQuestionnaire XLS (93 KB)  more ] Administration 11/21/2017
2005CT_SurveyForm XLS (105.5 KB)  more ] Administration 11/21/2017
2018_CHIRO_Facility_Patient_Log_Form_2018-10-.xlsx XLSX (17.03 KB) Administration 12/4/2018
2018_CHIRO_Facility_Patient_Log_Form_2018-10-2.pdf PDF (136.58 KB) Administration 12/4/2018
2018_CHIRO_Facility_Questionnaire_FINAL_2018-.xlsx XLSX (19.59 KB) Administration 12/4/2018
2018_CHIRO_State_Assignments_FINAL_2018-11-20.pdf PDF (42.59 KB) Administration 12/4/2018
2018_CHIRO_Survey_Protocol_FINAL_2018-11-20.xlsx XLSX (28.46 KB) Administration 12/4/2018
2018_NEXT_Chiro_Webinar_FAQ-Comments PDF (171.99 KB) Administration 2/26/2019
2018_NEXT_Survey_Support_Letter_ACA_ACCR_Final.pdf PDF (65.44 KB) Administration 12/4/2018
2018_NEXT_Survey_Support_Letter_ACA_ACCR_Final.pdf PDF (65.44 KB) Administration 11/1/2018
25 Years Of NEXT Trifold Rev_2-4-03 PDF (10.31 MB)  more ] Administration 11/22/2017
93DentalTrifold PDF (114.35 KB)  more ] Administration 8/2/2016
98PedsChestProtocol PDF (702.61 KB)  more ] Administration 11/21/2017
Administrative X-Ray: Results of a Nationwide Surv Link  more ] Administration 11/22/2017
FacilityQuestionnaireForPDFexport Aug02 XLS (74 KB)  more ] Administration 8/2/2016
NEXT 1989 Abdomen and Lumbo-Sacral Spine Survey in Link  more ] Administration 8/2/2016
NEXT 1992 Mammography X-Ray Data PDF (879.85 KB) Administration 8/2/2016
NEXT 1994 P/A Chest X-Ray Data PDF (991.44 KB) Administration 8/2/2016
NEXT 1995 Abdomen and LS Spine X-Ray Data PDF (66.24 KB)  more ] Administration 11/21/2017
NEXT 1995 Abdomen/Lumbosacral Spine Survey-Trifold Link  more ] Administration 11/22/2017
NEXT 1996 Fluoroscopy Survey-Trifold & Data Summar Link  more ] Administration 11/22/2017
NEXT 1996 Upper G.I. Fluoroscopy Survey PDF (209.79 KB)  more ] Administration 11/22/2017
NEXT 1998 Pediatric Chest X-Ray Data PDF (137.4 KB) Administration 8/2/2016
NEXT 1999 Dental Radiography Survey PDF (608.13 KB)  more ] Administration 11/21/2017
NEXT 1999 Dental X-Ray Data PDF (126.73 KB) Administration 8/2/2016
NEXT 2000 Computed Tomography PDF (110.1 KB)  more ] Administration 11/21/2017
NEXT 2000 Protocol for Survey of Computed Tomograp PDF (458.44 KB)  more ] Administration 11/21/2017
NEXT 2001 Adult Chest PDF (858.66 KB)  more ] Administration 11/21/2017
NEXT 2001 Adult Chest Protocol PDF (446.66 KB)  more ] Administration 11/21/2017
NEXT 2001 Adult Chest Radiography Trifold PDF (161.18 KB) Administration 9/26/2016
NEXT 2002 Abdomen LS Spine Survey PDF (2.36 MB)  more ] Administration 11/21/2017
NEXT 2002 Abdomen Radiography Survey Trifold PDF (581.08 KB)  more ] Administration 11/21/2017
NEXT 2002 Ab-LS_Protocol PDF (630.13 KB)  more ] Administration 8/2/2016
NEXT 2002 Lumbosacral (LS) Spine Radiography Sur.. PDF (633.7 KB)  more ] Administration 11/21/2017
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