## 4 Discussion
It was found that patients with high BMI and intensive care unit (ICU) referrals are associated with high CT radiation doses. These results are in agreement with our results, where the patient's BMI was found to correlate with the patient's DLP. Factors affecting patient ED have also been studied in the literature. [PERSON] et al. [26] focused on factors increasing patient ED while undergoing CT exams, including gender, age, obesity (higher BMI), and multiphase/repeat scanning using Spearman correlation coefficients and penalized quantile regression on abdomen/pelvis CT scans of patients under 16 years. It was found that older age, female gender, obesity, and multiphase or repeat scanning are all associated with increased effective doses from abdomen/pelvis CT. In another study by [PERSON] et al. [27], Pearson correlation analysis was conducted to explore the relationship between ED and the patient's BMI and abdominal fat in liver CT scans. A strong positive correlation between ED and both BMI (\(r\) = 0.715; \(p\)-value \(<\) 0.001) and TFA was found (\(r\) = 0.792; \(p\)-value \(<\) 0.001). The results above are in agreement with our results with respect to the patient's BMI, which was found to correlate with the patient's ED. Several studies have explored the relationship between SSDE and patient parameters. [PERSON] et al. [17] investigated the relationship between SSDE and patient related parameters, namely height, weight, effective diameter (Deff) and BMI, using linear regression models on a dataset of 400 thoracoabdominal CT adult examinations. Significant correlations were found between Deff, BMI and weight as surrogates for calculating SSDE. Their results are in agreement with our results with respect to patient BMI and weight, which were found to be correlated with the SSDE. Furthermore, [PERSON] et al. [28] explored the potential of using BMI as a size-related metric alternative to the mid-slice effective diameter to estimate SSDE in abdominal CT using linear regression. It was found that there is a correlation between patient BMI and mid-slice effective diameter; thus, patient BMI can be used to accurately estimate mid-slice effective diameter, which is necessary for calculating SSDE for abdominal CT. Moreover, [PERSON] et al. [29] evaluated the effect of patient size on absorbed dose for ultra-low-dose and standard CT. They noted an inverse relationship between patient size and ultra-low-dose CT, while SSDE increased with larger patient size due to higher abdominal fatty tissue percentage. In [30], a study was proposed to analyze the correlation between patient weight, BMI and water-equivalent diameter and SSDE for chest and abdomen-pelvic CT examinations. Using linear regression analysis, it was found that both patient weight and BMI can be used to calculate SSDE in the chest and abdomen-pelvis CT exams. Similar results were found in [31], where higher BMI contributed to increased radiation dose and SSDE in patients who had undergone chest or abdomen-pelvis CT examination. The results of the aforementioned studies are in accordance with our results, where patient BMI and weight were found to be correlated with SSDE. The relationship between several dose indices has been studied in the literature. In a study proposed by [PERSON] et al. [12], the relationship between SSDE and both CTDIvol and DLP in chest CT exams was investigated. It was found that the CTDIvol value depends on the lateral diameter of the patient's body. The CTDIvol value varied as the lateral body diameter of each patient varied, which also resulted in greater variation in SSDE. Moreover, their results showed that different SSDE values were seen for patients with different BMI values. [PERSON] et al. [22] observed a high linear correlation between CTDI\({}_{\text{vol}}\) and SSDE. Similar results could be obtained using clustering algorithms [32] and numerical methods [33]. [PERSON] et al. [34] proposed a study aiming to determine the factors that impact SSDE for chest-abdomen-pelvis and abdomen-pelvis CT exams.