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Zak TK, Zmugg S, Bouton D, Rodgers J, Kalia V, Stewart N, Polk J, Brown K, Kanaan Y, Riccio AI. Insights into Testicular Radiation Exposure in the Orthopedic Surgeon. HEALTH PHYSICS 2025:00004032-990000000-00256. [PMID: 40333437 DOI: 10.1097/hp.0000000000001993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2025]
Abstract
ABSTRACT Testicular radiation exposure has been linked to diminished spermatogenesis, male infertility, and potentially testicular cancer. Despite this, the risk of testicular exposure from intraoperative fluoroscopy to the male orthopedic surgeon has yet to be studied. The purpose of this study is to determine factors associated with unnecessary testicular radiation exposure in male orthopedic surgeons. The study was designed to answer the following questions: (1) Do the designs of lead apron protection result in any differential testicular radiation exposure? (2) Does the position of the surgeon (standing, sitting, and knee position while sitting) alter the amount of testicular radiation exposure? (3) Does any combination of lead apron design and surgeon positioning increase the degree of testicular radiation exposure? A life-sized, whole-body, anthropomorphic phantom simulating an orthopedic surgeon was positioned adjacent to a hand table attached to a standard radiolucent operating table. A digital dosimeter was attached to the groin region beneath a lead apron. Scatter radiation dose equivalent rates were measured during continuous anteroposterior C-arm fluoroscopy of a forearm/hand phantom. Four trials were conducted using three different types of protective lead aprons (cross-back, full-skirt, and half-skirt) in three different positions (standing, sitting with knees 10 cm apart, and sitting with knees 25 cm apart). Radiation dose-equivalent rates were compared using the Student's t-test and analysis of variance. No scatter radiation (measured value of 0.0 mrem min-1 [0.0 Sv min-1]; below minimum detectability of dosimeter) was detected underneath the lead aprons in the standing position and when sitting with the knees 25 cm apart, using all three types of lead. When sitting with the knees 10 cm apart, the mean dose equivalent rate of scatter radiation was higher using the half-skirt (0.01 mrem min-1 [0.000001 Sv min-1]) than the cross-back (below minimum detectability of dosimeter) and skirt aprons (below minimum detectability of dosimeter), but this did not reach statistical significance (p = 0.44). For all apron types and all positions, the use of an apron resulted in significantly less scatter radiation exposure when compared to no protection (p < 0.001). Protective lead aprons are effective at preventing testicular radiation exposure in both the standing and sitting positions. As the only detectable radiation exposure occurred with use of a half-skirt apron when sitting with the knees spread 10 cm apart, cross-back and full-skirt aprons may provide slightly enhanced protection over half-skirt aprons in the sitting position.
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Affiliation(s)
- Taylor K Zak
- Department of Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX
| | - Stephan Zmugg
- Department of Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX
| | - Daniel Bouton
- Department of Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX
| | - Jennifer Rodgers
- Department of Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX
| | - Vivek Kalia
- Department of Radiology, Scottish Rite for Children, Dallas, TX
| | - Neil Stewart
- Department of Radiology, Scottish Rite for Children, Dallas, TX
| | - Jordan Polk
- Department of Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX
| | - Kaitlyn Brown
- Department of Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX
| | - Yassine Kanaan
- Department of Radiology, Scottish Rite for Children, Dallas, TX
| | - Anthony I Riccio
- Department of Orthopaedic Surgery, Scottish Rite for Children, Dallas, TX
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Matković A, Ferenc T, Dimjašević L, Drinković M, Marelić M, Matković BR, Vidjak V, Popić J. Knowledge and perceptions of ionising radiation among Croatian general practitioners: is there cause for concern? Arh Hig Rada Toksikol 2025; 76:24-30. [PMID: 40222178 PMCID: PMC11994234 DOI: 10.2478/aiht-2025-76-3916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2024] [Revised: 11/01/2024] [Accepted: 02/01/2025] [Indexed: 04/15/2025] Open
Abstract
Recent data suggest that general practitioners (GPs) are insufficiently familiar with health risks associated with ionising radiation and radiation doses. The aim of our cross-sectional study was therefore to see if this holds true for Croatian GPs. To do that, we distributed a questionnaire about ionising radiation and doses used in various radiological procedures by email or by handing it out to participants at a national GP conference. We received responses from 120 participating GPs. Most were women (83.1 %), and the mean participant age was 44.2 years (range 26-65) with mean practice of 17.1 years (range 1-40). Most participants (97 %) believed patients should be informed about the procedures they were referred to. All respondents knew that radiological procedures irradiate the patient's body, but not everyone agreed that they could be harmful. Less than half (47 %) thought that exposure to a single irradiation dose was enough to increase cancer risk. Most participants (89.2 %) identified X-ray scans as the largest irradiation source, whereas three GPs replied that computed tomography (CT) and conventional X-ray procedures did not involve radiation. Some respondents did not know if ultrasound involved ionising radiation. Although most GPs were women, only 21.7 % correctly identified the radiation dose in mammography. Our findings confirm inadequate GPs' knowledge of radiation exposures and call for better training programmes as part of continuing professional development.
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Affiliation(s)
- Andro Matković
- Merkur University Hospital, Department of Diagnostic and Interventional Radiology, Zagreb, Croatia
| | - Thomas Ferenc
- Merkur University Hospital, Department of Diagnostic and Interventional Radiology, Zagreb, Croatia
| | - Lucija Dimjašević
- Merkur University Hospital, Department of Diagnostic and Interventional Radiology, Zagreb, Croatia
| | | | - Marko Marelić
- University of Zagreb School of Medicine, Andrija Štampar School of Public Health, Zagreb, Croatia
| | | | - Vinko Vidjak
- Merkur University Hospital, Department of Diagnostic and Interventional Radiology, Zagreb, Croatia
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Jelena Popić
- University of Zagreb School of Medicine, Zagreb, Croatia
- University Hospital Dubrava, Department of Diagnostic and Interventional Radiology, Zagreb, Croatia
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Zheng L, Yang H, Xie T, Huang D, Tian H. Knowledge and attitudes toward [ 18F] fluorodeoxyglucose ( 18F-FDG) positron emission tomography/computed tomography among non-radiologist medical staff. BMC MEDICAL EDUCATION 2025; 25:306. [PMID: 40001203 PMCID: PMC11863951 DOI: 10.1186/s12909-025-06864-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 02/12/2025] [Indexed: 02/27/2025]
Abstract
BACKGROUND To investigate the current knowledge and attitudes towards [18F]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) among non-radiologist medical staff in China. METHODS This cross-sectional study was conducted between November 18, 2022, and December 6, 2022, at the First Affiliated Hospital (Southwest Hospital) of the Army Medical University (Third Military Medical University) among non-radiologist staff (medical, nursing, and others). The questionnaire survey (Cronbach's α = 0.887) included 28 items: 10 on demographics, 11 on knowledge (maximum score of 22), and seven on attitudes (maximum score of 35). The factors influencing knowledge and attitudes were identified using multivariable logistic regression analysis. RESULTS This study analyzed 631 valid questionnaires. The mean knowledge score was 7.16 ± 6.48 (32.55%), indicating poor knowledge. The mean attitude score was 22.859 ± 2.36 (65.29%), indicating positive attitudes. Nursing (OR = 0.301, 95%CI: 0.159-0.571), other occupations (OR = 0.426, 95%CI: 0.200-0.905), departments with high volumes of PET/CT prescriptions (OR = 0.419, 95%CI: 0.269-0.652), radioprotection training (OR = 2.520, 95%CI: 1.576-4.030), underwent (or a relative) a PET/CT (OR = 1.713, 95%CI: 1.063-2.761), and contact with 1-10 (OR = 2.429, 95%CI: 1.627-3.627) or > 10 (OR = 3.575, 95%CI: 1.762-7.252) patients per month were independently associated with higher knowledge scores. Only the knowledge scores (OR = 1.063, 95%CI: 1.032-1.094) were independently associated with higher attitude scores. CONCLUSION Non-radiologist medical staff members in China have poor knowledge but positive attitudes toward PET/CT. This study identified knowledge areas worth improving in future training interventions. Radioprotection training appears particularly useful in improving the knowledge of PET/CT, which should translate into more favorable attitudes. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Lei Zheng
- Nuclear Medicine Department, The First Affiliated Hospital (Southwest Hospital), Army Medical University (Third Military Medical University), Gao Tan Yan Street, Chongqing, 400038, China
| | - Hang Yang
- Nuclear Medicine Department, The First Affiliated Hospital (Southwest Hospital), Army Medical University (Third Military Medical University), Gao Tan Yan Street, Chongqing, 400038, China
| | - Tianxin Xie
- Nuclear Medicine Department, The First Affiliated Hospital (Southwest Hospital), Army Medical University (Third Military Medical University), Gao Tan Yan Street, Chongqing, 400038, China
| | - Dingde Huang
- Nuclear Medicine Department, The First Affiliated Hospital (Southwest Hospital), Army Medical University (Third Military Medical University), Gao Tan Yan Street, Chongqing, 400038, China.
| | - Haiying Tian
- Oncology Department, The First Affiliated Hospital (Southwest Hospital), Army Medical University (Third Military Medical University), Gao Tan Yan Street, Chongqing, 400038, China.
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Özkent MS, Kılınç MT, Göger YE, Pişkin MM. Do urologists actually comply with the ALARA principle in pediatric urolithiasis management? Urolithiasis 2025; 53:36. [PMID: 39985676 DOI: 10.1007/s00240-025-01705-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 02/03/2025] [Indexed: 02/24/2025]
Abstract
The purpose of the study was to determine the urologists' knowledge of ionizing radiation and the frequency of CT scan utilization for pediatric patients with urolithiasis. The second aim is to examine the factors that affect the choice of the CT imaging method in these patients. We sent a quantitative online questionnaire to urologists and pediatric urologists in various regions and practice settings of Turkey via a web survey database in June 2022. The survey consisted of 22 items in a multiple-choice or yes/no format and was divided into three sections: participant characteristics, knowledge, and current practice. One hundred and fifty-four participants fully completed this questionnaire. Forty-two participants (27.3%) correctly stated the radiation dose of an abdominal CT scan. Thirty of the participants (19.5%) thought that there was no relationship between exposure to radiation and cancer development. In addition, 76 participants (49.4%) were aware of any scientific literature about this relationship. Ninety-eight participants (63.6%) think that they did not receive adequate training on imaging methods for pediatric patients during their residency program. The choice of CT scans as the first imaging method was increased with age. Even if the choice of imaging method is mostly decided according to the guidelines, various factors such as medicolegal causes, long ultrasound appointment dates, poor quality of assessment, and clinical experiences are inevitable facts that guide the choice of computed tomography. Urologists are responsible for knowing the effects of ionizing radiation and the ALARA principle. Our findings emphasize the lack of knowledge about ionizing radiation. Encouragement of the literature, provision of the mandatory curriculum, and supervision of the use of ionizing radiation will contribute to the elimination of the deficiency in this area.
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Affiliation(s)
| | | | - Yunus Emre Göger
- Department of Urology, School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Mesut Pişkin
- Department of Urology, School of Medicine, Necmettin Erbakan University, Konya, Turkey
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Karavas E, Ece B, Aydın S, Kocak M, Cosgun Z, Bostanci IE, Kantarci M. Are we aware of radiation: A study about necessity of diagnostic X-ray exposure. World J Methodol 2022; 12:264-273. [PMID: 36159099 PMCID: PMC9350723 DOI: 10.5662/wjm.v12.i4.264] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/27/2022] [Accepted: 06/03/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Total exposure to ionizing radiation has nearly doubled in the last two decades. This increase is primarily due to increased computed tomography (CT) exposure. Concerns have been raised about the risks associated with patients' exposure to medical imaging radiation, which can increase a person's lifetime risk of developing cancer. Preventing unnecessary examinations becomes critical at this point. To avoid unnecessary examinations, it is necessary to understand the demanding process. AIM To ascertain clinicians' awareness of and reasons for requesting a CT examination. METHODS We developed an online questionnaire that included 20 questions about clinicians' awareness of radiation safety and their reasons for requesting a CT examination, as well as demographic information such as age, gender, and year of medical practice experience. Additionally, we asked participants the number of CT scans requested in a month, the patients' questions and approaches about the imaging method, the effect of the patient's previous imaging history on the current imaging request, whether they believed that they had sufficient information about radiation doses, and whether they requested CT without an indication. We administered the questionnaire to clinicians from a variety of different professions in four different cities. RESULTS A total of 195 clinicians participated. Internal medicine specialists were the most crowded group (38/195, 19.5%). Mean age of the population was 33.66 ± 5.92 years. Mean year of experience was 9.01 ± 5.96. Mean number of requested CT scans in a month was 36.88 ± 5.86. Forty-five (23.1%) participants stated that they requested CT scans without clinical indication. The most common reasons for CT scan requests were work load, fear of malpractice, and patient demand/insistence. CONCLUSION CT scan requests are influenced by a variety of factors, both internal and external to the doctors and patients. Raising awareness of radiation safety and reducing fear of malpractice by limiting the number of patients per physician may result in a reduction in unnecessary CT examinations and ionizing radiation exposure.
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Affiliation(s)
- Erdal Karavas
- Department of Radiology, Erzincan University, Erzincan 24142, Turkey
| | - Bunyamin Ece
- Department of Radiology, Kastamonu University, Kastamonu 37150, Turkey
| | - Sonay Aydın
- Department of Radiology, Erzincan University, Erzincan 24142, Turkey
| | - Mehmet Kocak
- Department of Radiology, Bolu İzzet Baysal State Hospital, Bolu 14300, Turkey
| | - Zeliha Cosgun
- Department of Radiology, Bolu Abant Izzet Baysal University, Bolu 14030, Turkey
| | - Isil Esen Bostanci
- Department of Radiology, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara 06200, Turkey
| | - Mecit Kantarci
- Department of Radiology, Erzincan University, Erzincan 24142, Turkey
- Department of Radiology, Atatürk University, Erzurum 25240, Turkey
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Kannaujia A, Haldar R, Shamim R, Mondal H, Mishra P, Agarwal A. A survey on knowledge, attitude, and practices of workplace radiation safety amongst anaesthesiology personnel in northern Indian tertiary care institutes. Indian J Anaesth 2022; 66:S137-S147. [PMID: 35774241 PMCID: PMC9238231 DOI: 10.4103/ija.ija_838_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 09/10/2021] [Accepted: 12/06/2021] [Indexed: 11/23/2022] Open
Abstract
Background and Aims: Exposure to ionising radiation to Anaesthesiology consultants, residents, technicians and nurses (Anaesthesiology personnel) is steadily increasing as a consequence of growing usage of imaging technology for diagnostic and therapeutic purposes. We conducted a questionnaire-based survey of Anaesthesiology professionals (consultants, residents, technicians and nursing staff) working in three major tertiary care medical institutes in northern India regarding the existing knowledge, attitudes and practices of radiation safety at their workplaces. Methods: A printed and validated 30-point questionnaire was distributed. Questions were graded into the domains of demographics (6 questions), knowledge (9 questions), attitude (4 questions) and practice (11 questions). Data obtained from the responses was collated and analysed statistically Results: Out of the 403 questionnaires distributed, 222 were returned completed (55%). Majority of the respondents were residents (53.60%) and males (57.20%). Many were unaware of the principle of As Low As Reasonably Achievable (ALARA), (70.7%) regarding collimators (65.85%) and their usage (41.9%). Maximum respondents stressed on the necessity of knowing the exposure dosage of radiations (89.2%) and were concerned regarding the same (87.8%). Lead apron was the commonest protection equipment and 97.3% of them were not using dosimeters. Highest levels of knowledge, attitude, and practices were demonstrated by the consultants. In terms of practices, the technicians fared better than the residents. Conclusion: Knowledge, attitude and practices regarding radiation protection issues and doses of radiological procedures is limited. Although all the cadres scored high on their attitude scores, the practice sector requires improvement.
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Kumar V, Kumar Pal A, Ks S, Manikandan R, Dorairajan LN, Kalra S, Kandasamy S, Khan M. Effect of Structured Educational Program on Practices of Radiation Safety Measures Among Health Care Providers in Urology Operation Theater. Cureus 2021; 13:e15765. [PMID: 34295578 PMCID: PMC8291469 DOI: 10.7759/cureus.15765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Endourologists are at increased risk of exposure to radiations. Many studies are available that have studied awareness in doctors in general, but very few studies available regarding any intervention to improve the knowledge of radiation safety measures. We have made an attempt to study the role of an educational intervention to improve the knowledge of our Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) urology operation theater health care providers (HCPs). Materials and methods Our study was an Interventional study (prospective clinical trial), conducted in the Department of Urology, JIPMER from January 2017 to March 2018. All, that is, 40 operation theater HCPs were given a questionnaire as baseline. The baseline response was compared to the response after the Structured Education Program (SEP) by using the same questionnaire. The knowledge of participants before SEP was compared with the knowledge after SEP using the chi-square test. All statistical analysis was carried out at a 5% level of significance and p-value < 0.05 was considered as significant. Result In our study after SEP, participants use of lead apron has increased from 72.5% to 92.5%, indicating improvement. There is an increase in the use of thyroid shield from 22.5% to 95%. In our study after SEP, knowledge about background radiations improved in participants from 25% to 87.5%. Knowledge about Radiation dose of chest X-ray improved from 22.5% to 52.5%. Knowledge about ALARA (As Low As Reasonably Achievable) improved from 47.5% to 95% after SEP. Knowledge that MRI and USG do not have ionizing radiation improved from 62.5% to 97.5%, and from 75% to 92.5% for MRI and USG, respectively, after SEP. Regarding organ sensitivity, 100% HCPs had given correct answers after SEP as compared to 80 before SEP. Conclusion Our study shows that SEP at regular intervals has made significant improvements in daily practice in operation theater HCPs. SEP has increased the use of radiation protective gears among HCP. Hence we recommend SEP at regular intervals for urology operation theater HCPs for a healthy and safe working environment.
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Affiliation(s)
- Vijay Kumar
- Urology and Renal Transplantation, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND
| | - Atanu Kumar Pal
- Urology and Renal Transplantation, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND
| | - Sreerag Ks
- Urology and Renal Transplantation, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND
| | - Ramanitharan Manikandan
- Urology and Renal Transplantation, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry, IND
| | - Lalgudi N Dorairajan
- Urology and Renal Transplantation, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry, IND
| | - Sidhartha Kalra
- Urology and Renal Transplantation, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry, IND
| | - Saravanan Kandasamy
- Medical Physics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND
| | - Mujahid Khan
- Urology and Renal Transplantation, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND
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Evaluation and analysis of entrance surface air kerma of the thyroid gland during breast cancer screening mammography. RADIATION MEDICINE AND PROTECTION 2021. [DOI: 10.1016/j.radmp.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
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Naderi M, Salehi F, Maleki S, Zahabi KS, Zahabi SS. The need to increase patient awareness of radiation exposure in imaging modalities: A study on the awareness and attitude of patients. J Med Imaging Radiat Sci 2021; 52:450-455. [PMID: 34045169 DOI: 10.1016/j.jmir.2021.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 03/17/2021] [Accepted: 05/01/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND A decline in requests for unnecessary imaging can be achieved through increased patient awareness about imaging modalities and can thus reduce radiation exposure. This study aimed to evaluate patient awareness and attitude about radiation exposure in various imaging modalities. METHODS This cross-sectional study was performed on 900 patients and used a 12-item questionnaire, of which 824 were fulfilled and analyzed. Statistical analysis was done using SPSS software version 18. RESULTS The age of respondents ranged from 18-82; most participants were male (71.5%). The highest patient-estimated radiation exposures were for radiology, CT scans, and mammography. More than 20% of individuals believed that ionizing radiation (IR) is used in MRI, and 60% stated that IR is not used in mammography. Results show a significant statistical difference between attitude and behavior of respondents on the question about knowing who to address questions to in regard to amount of radiation, but they asked the person who is more accessible such as a radiology technologist instead of a medical physicist (P < 0.05). In addition, there was significant statistical difference between question 3 (X-ray is used in which method of radiation?) and question 4 (scoring of radiation exposure in each of the imaging modalities; Score one means no radiation, score has more than one meaning of rays), which indicates accuracy of responses of referees (P <0.05). 73.4% of individuals agree about the importance of reduction of radiation during imaging, and most of the individuals (87%) tended to be aware of radiation exposure in each of imaging modalities. CONCLUSION Given the low patient awareness about imaging modalities and radiation dose, it is recommended to prepare brochures and guidance about radiation exposure and absorbed doses in each modality, to be provided and displayed in imaging clinics.
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Affiliation(s)
- Mehdi Naderi
- Clinical Research development center of Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farkhondeh Salehi
- Clinical Research development center of Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shokofeh Maleki
- Clinical Research development center of Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kharaman Salehi Zahabi
- Clinical Research development center of Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saleh Salehi Zahabi
- Clinical Research development center of Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran; Department of Radiology and nuclear medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Awadghanem A, Sbaih M, Hasoon M, Yassin Z, Samara AM, Maree M, Zyoud SH. An assessment of medical students' proficiency regarding the hazards of radiological examinations on the health of workers and patients: a cross-sectional study from Palestine. J Occup Med Toxicol 2020; 15:35. [PMID: 33292346 PMCID: PMC7713170 DOI: 10.1186/s12995-020-00287-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 11/24/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The use of radiological examination is increasing worldwide. Since radiation exposure can result in many health hazards, medical professionals, as well as medical students, should possess adequate knowledge regarding radiation and its related hazards to protect themselves and the patients. Many studies have assessed medical students' knowledge on this topic, but never in Palestine. In this study, we aimed to examine Palestinian medical students' awareness and knowledge regarding radiological examination modalities and their risks on themselves and their patients. METHODS This was an observational, cross-sectional, population-based study, conducted to assess the awareness of radiation exposure and its risks among Palestinian medical students. An online questionnaire was implemented on medical students at An-Najah National University. A total knowledge score that ranged from 0 to 22 was calculated for each participant, with higher scores indicating better knowledge regarding radiation doses and the related hazards. RESULTS Two hundred eighty and seven students participated in our study, with a response rate of 71%. The average knowledge score of the participants was 10.97 ± 4.31 out of a maximum of 22 points. Male participants and participants in advanced study years achieved better knowledge scores (p-values were 0.034 and < 0.001, respectively). Perceived radiology knowledge was significantly associated with the actual knowledge score among the participants (p-value< 0.001). Receiving radiology lectures in fourth and fifth years significantly affected the participants' knowledge score (p-values were < 0.001). CONCLUSIONS We found a severe lack of knowledge regarding radiation doses and related risks among medical students. Therefore, we recommend that medical schools update and supplement their curriculum regarding knowledge on radiation.
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Affiliation(s)
- Ahmed Awadghanem
- Department of Radiology, An-Najah National University Hospital, Nablus, 44839 Palestine
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Mahmoud Sbaih
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Mohammad Hasoon
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Zaher Yassin
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ahmad M. Samara
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Mosab Maree
- Department of Radiology, An-Najah National University Hospital, Nablus, 44839 Palestine
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Sa’ed H. Zyoud
- Department of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839 Palestine
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Zekioğlu A, Parlar Ş. Investigation of awareness level concerning radiation safety among healthcare professionals who work in a radiation environment. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2020. [DOI: 10.1080/16878507.2020.1777657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Aysu Zekioğlu
- Faculty of Health Sciences, Health Management Department, Trakya University, Edirne, Turkey
| | - Şule Parlar
- Vocational School of Health, Radiotherapy Department, Trakya University, Edirne, Turkey
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[Success, satisfaction and improvement of informed consents for computed tomography : A survey among patients and physicians]. Radiologe 2020; 60:1077-1084. [PMID: 32728857 PMCID: PMC7595969 DOI: 10.1007/s00117-020-00727-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Hintergrund Die Aufklärung eines Patienten vor einer Computertomographie (CT) spielt sowohl für die aufklärenden Ärzte als auch für die Patienten eine entscheidende Rolle. Ein persönliches Aufklärungsgespräch über die Durchführung, Risiken und mögliche Alternativen ist vor einer CT-Untersuchung verpflichtend. Methode Durchgeführt wurde eine Befragung zur Patientenzufriedenheit hinsichtlich der Dauer und den Inhalten einer CT-Aufklärung. Befragt wurden hierüber auch aufklärende Ärzte. Ein weiterer Teil der Befragung beschäftigte sich mit der Akzeptanz technischer Hilfsmittel, wie z. B. Informationsvideos oder Tablets/PCs. Ergebnis Insgesamt 512 Patienten und 106 Ärzte beteiligten sich an der Befragung. Die Dauer des Aufklärungsgesprächs gaben die Patienten mit durchschnittlich 4,08 min und die Ärzte mit 4,7 min an. Am ausführlichsten klärten die Ärzte über die Nebenwirkungen von Kontrastmitteln auf. Über mögliche Alternativen und die Notwendigkeit der Untersuchung wurde weniger aufgeklärt. Korrelierend erinnerten sich rund 92 % aller Patienten nicht an eine Information über alternative Untersuchungsmöglichkeiten. 88,7 % der Patienten und 95,3 % der ärztlichen Teilnehmer befürworteten die Aufklärung mithilfe von interaktiven Videos und Animationen und 74 % der Patienten sowie 98,8 % der Ärzte die Beantwortung der Fragen zum Gesundheitszustand am Tablet/PC. Schlussfolgerung Die Dauer einer CT-Aufklärung wurde von den Patienten etwas kürzer eingeschätzt, wobei sich die Patienten teilweise nur schlecht an die Aufklärungsinhalte erinnerten. Die Akzeptanz gegenüber technischen Neuerungen war bei den Teilnehmern sehr hoch. Durch den Einsatz von Informationsvideos und Tablets/PCs könnte der Aufklärungserfolg erhöht werden.
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Javed H, Imran M, Nazir QUA, Fatima I, Humayun A. Increased trend of unnecessary use of radiological diagnostic modalities in Pakistan: radiologists perspective. Int J Qual Health Care 2020; 31:712-716. [PMID: 30476150 DOI: 10.1093/intqhc/mzy234] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/13/2018] [Accepted: 10/29/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Over the past few years, a significant overuse of radiological investigations influenced the quality and cost of healthcare of the country as it may lead to non-compliance of the patient due to non-affordability and also may harm the patient in terms of radiation hazards. Pakistan, being a low-income, resource-constraint country, is facing financial impact on families as well as health system due to multiple reasons. OBJECTIVES The purpose of study is to identify reasons of unnecessary use of radiological diagnostic modalities in Pakistani hospitals as perceived by radiologists. METHODS A cross-sectional study was conducted on a total of all 105 radiologists, having at least 1 year experience of working in radiology, working in five tertiary care hospitals in Lahore. A self-constructed, self-administered, pretested 5-point Likert scale opinion-based questionnaire was administered after taking informed consent. It includes questions about excessive radiological use that may be attributed to the physicians, investigations, patients and other non-categorized causes. Results were analyzed using SPSS version 23. RESULTS Since the assessment forms were handed over and collected from the radiologists in person, the response rate was 100%. Of a total of 105 respondents, 78 (74.28%) respondentsagreed that there is an actual increase, 25 (23.80%) respondents disagreed and 2 (1.90%) respondents were unsure. Most important reasons for increased usage of radiological investigations are 'need of accuracy of diagnosis' (P = 0.009), 'trend of physicians to repeat tests in order to confirm preset diagnoses' (P-value = 0.03), 'lack of knowledge about proper usage of radiological advances' (P-value = 0.005) and 'lack of proper clinical examination' (P-value = 0.04). CONCLUSION Unnecessary use of radiological investigations is actually there as perceived by radiologists, which is attributed to inadequate knowledge, attitude and training of physicians to refer patients to radiological resources. This research can be a stepping stone for future researchers as it can be used for elaborating these causes individually and finding ways as to how each of these causes can be controlled and minimized to bring about a decline in excessive usage of these modalities for the betterment of the patients.
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Affiliation(s)
- Hassan Javed
- Department of Public Health and Community Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan Medical College, Shaikh Zayed Postgraduate Medical Institute, Shaikh Zayed Medical Complex, Lahore, Pakistan
| | - Mahum Imran
- Department of Public Health and Community Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan Medical College, Shaikh Zayed Postgraduate Medical Institute, Shaikh Zayed Medical Complex, Lahore, Pakistan
| | - Qurrat-Ul-Ain Nazir
- Department of Public Health and Community Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan Medical College, Shaikh Zayed Postgraduate Medical Institute, Shaikh Zayed Medical Complex, Lahore, Pakistan
| | - Iram Fatima
- Institute of Quality Management, University of the Punjab, Lahore, Pakistan
| | - Ayesha Humayun
- Department of Public Health and Community Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan Medical College, Shaikh Zayed Postgraduate Medical Institute, Shaikh Zayed Medical Complex, Lahore, Pakistan
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Ribeiro AS, Husson O, Drey N, Murray I, May K, Thurston J, Oyen WJ. Radiation exposure awareness from patients undergoing nuclear medicine diagnostic 99mTc-MDP bone scans and 2-deoxy-2-(18F) fluoro-D-glucose PET/computed tomography scans. Nucl Med Commun 2020; 41:582-588. [PMID: 32187158 PMCID: PMC7242175 DOI: 10.1097/mnm.0000000000001177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 02/12/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Medical imaging is on average the largest source of artificial radiation exposure worldwide. This study seeks to understand patient's awareness of radiation exposure derived from nuclear medicine diagnostic scans and assess if current information provided by leaflets is adequate. METHODS Single-centre cross-sectional questionnaire study applied to bone scan and FDG PET/computed tomography patients, at a nuclear medicine and PET/computed tomography department over a 15-week period in 2018. Questionnaires on dose comparators were designed in collaboration with patients, public, and experts in radiation exposure. Qualitative data were analysed using thematic analysis and quantitative data using SPSS (V. 24). RESULTS A total of 102 questionnaires were completed (bone scan = 50; FDG PET/computed tomography = 52). Across both groups, 33/102 (32.4%) patients reported having a reasonable understanding of nuclear medicine and 21/102 (20.6%) reported a reasonable knowledge of ionising radiations. When asked to compare the exposure dose of respective scans with common comparators 8/50 (16%) of bone scan patients and 11/52 (21.2%) FDG PET/computed tomography answered correctly. On leaflet information, 15/85 (17.6%) patients reported the leaflets do not provide enough information on radiation exposure and of these 10/15 (66.7%) commented the leaflets should incorporate more information on radiation exposure dose. CONCLUSION More observational and qualitative studies in collaboration with patients are warranted to evaluate patients' understanding and preferences in communication of radiation exposure from nuclear medicine imaging. This will ensure communication tools and guidelines developed to comply with ionising radiation (medical exposure) regulation 2017 are according to patients needs and preferences.
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Affiliation(s)
| | | | | | - Iain Murray
- The Royal Marsden Hospital NHS Foundation Trust
| | | | | | - Wim J.G. Oyen
- The Royal Marsden Hospital NHS Foundation Trust
- Institute of Cancer Research, Sutton
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J A A, M A A, M R U, C A A. Assessment of Patient Absorbed Radiation Dose during Hysterosalpingography: A Pilot Study in Southwest Nigeria. J Biomed Phys Eng 2020; 10:131-140. [PMID: 32337179 PMCID: PMC7166218 DOI: 10.31661/jbpe.v0i0.1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 12/10/2018] [Indexed: 06/11/2023]
Abstract
BACKGROUND Hysterosalpingography (HSG) is an indispensable tool for diagnosing infertility in females. The procedure exposes female reproductive organs to ionizing radiation as the genitals are irradiated during the process. Investigating patient absorbed dose during the procedures is essential for effective radiological protection of the patient. OBJECTIVE This study aims to investigate the radiation dose received by patient during HSG examination in the study environment in order to enhance optimization of procedures and the associated dose, thereby minimizing radiation risks. MATERIAL AND METHODS The prospective pilot study, was conducted in four tertiary healthcare institutions in Southwest Nigeria. Thermoluminescence dosimeter (TLD 100) was used to determine the Entrance Surface Dose (ESD) of 80 patients presented for HSG investigation. The corresponding effective dose, ovary, uterus and urinary bladder doses were evaluated using PCXMC software. RESULTS The mean entrance surface doses (ESD) obtained from the four centers were 18.58±6.31 mGy, 15.18±2.27 mGy, 17.44±3.43 mGy and 34.24±11.98 mGy for SW1, SW2, SW3 and SW4 centers, respectively. The corresponding mean of effective doses were 1.54±0.63 mSv, 1.24±0.28 mSv, 1.41±0.30 mSv and 2.53±0.94 mSv for SW1, SW2, SW3 and SW4 centers, respectively. The resulting mean doses to the ovary, urinary bladder and uterus were also presented. CONCLUSION The results obtained in general are comparable with international standards. It was, however, recommended that study centers with high doses should conduct dose audit in order to enhance patient safety.
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Affiliation(s)
- Achuka J A
- PhD, Department of Physics, Covenant University Ota, Ogun State, Nigeria
| | - Aweda M A
- PhD, Department of Radiation Biology, Radiotherapy and Radiodiagnosis, College of Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Usikalu M R
- PhD, Department of Physics, Covenant University Ota, Ogun State, Nigeria
| | - Aborisade C A
- PhD, Department of Physics and Engineering Physics, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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Zervides C, Sassis L, Kefala-Karli P, Christou V, Derlagen A, Papapetrou P, Heraclides A. Assessing radiation protection knowledge in diagnostic radiography in the Republic of Cyprus. A questionnaire survey. Radiography (Lond) 2020; 26:e88-e93. [PMID: 32052768 DOI: 10.1016/j.radi.2019.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Radiation protection knowledge is essential for medical personnel in ensuring that the possible risks do not outweigh the benefits of diagnostic imaging. This study aimed to assess the radiation protection knowledge of radiographers in Cyprus. METHODS A cross-sectional study was carried out among radiographers in Cyprus through the Cyprus Society of Registered Radiologic Technologists & Radiation Therapy Technologists. The study was a quantitative descriptive analysis, using a questionnaire with 22 multiple-choice questions. Analysis of the data was done using the statistical software Stata, by performing mean knowledge score comparisons by different participants' characteristics, using t-test and analysis of variance test. Statistical significance was assumed as a p-value < 0.05. RESULTS The answers provided for each question indicate that some areas of radiation protection are less known compared to others, as there is quite a wide range of correct-to-incorrect ratios. The analysis based on participant characteristics in relation to overall radiation effects knowledge, identified important determinants, namely the workplace of the participant (p = 0.006), the type of work licence the participant held at the time of the questionnaire (p = 0.024), and the years of clinical experience of the participant (p = 0.021). CONCLUSION The study showed that the levels of knowledge in radiation protection are of a very good standard. However, work is needed to clarify the specifics of dose limits and the national radiation protection legislation with regards to informing patients about the possible effects of ionising radiation. IMPLICATIONS FOR PRACTICE The study results indicate the importance of educating radiographers about the requirements of national radiation protection legislation and how this new knowledge can be linked with practise.
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Affiliation(s)
- C Zervides
- University of Nicosia Medical School, Cyprus.
| | - L Sassis
- University of Nicosia Medical School, Cyprus
| | | | - V Christou
- University of Nicosia Medical School, Cyprus
| | - A Derlagen
- University of Nicosia Medical School, Cyprus
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Hankin RA, Jones SP. The impact of educational interventions on clinicians' knowledge of radiation protection: An integrative review. Radiography (Lond) 2020; 26:e179-e185. [PMID: 32052790 DOI: 10.1016/j.radi.2020.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVES The aim of this review is to explore the impact of educational interventions on clinicians' knowledge of radiation protection. KEY FINDINGS Following a comprehensive search of MEDLINE and EMBASE from 2000 to 2018, 1795 studies were identified, eight of which met the criteria for this review. All eight studies utilised pretest-posttest designs and involved the education of medical students or doctors. All studies reported an increase in participants' knowledge of radiation protection, five of which were statistically significant. In two studies, over half of participants stated that education received would impact on their future imaging requesting practice. CONCLUSION Whilst a range of educational interventions have been shown to improve knowledge of radiation protection, there was wide variation in the study settings and type of educational programmes delivered. No studies assessed long-term knowledge retention or the impact on clinical practice. Therefore, robust research is needed to accurately measure the impact of educational programmes on knowledge of radiation protection in the UK and the implications this may have on referral practices. IMPLICATIONS FOR PRACTICE This review revealed that educational interventions are effective in increasing participants' knowledge levels of radiation protection. It is necessary to assess and ensure that this improvement in knowledge actually translates into an impact on referral practice/behaviour. The ideal outcome being that fewer unnecessary examinations are requested and our patients are protected from a needless increased radiation burden.
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Affiliation(s)
- R A Hankin
- Main X-ray, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Sharoe Green Lane, Fulwood, Preston, PR2 9HT, UK.
| | - S P Jones
- Brook Building Room 445, School of Nursing, University of Central Lancashire, Preston, PR1 2HE, UK.
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Khamtuikrua C, Suksompong S. Awareness about radiation hazards and knowledge about radiation protection among healthcare personnel: A quaternary care academic center-based study. SAGE Open Med 2020; 8:2050312120901733. [PMID: 32030128 PMCID: PMC6977219 DOI: 10.1177/2050312120901733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 01/02/2020] [Indexed: 11/16/2022] Open
Abstract
Background: The use of medical radiation in diagnosis and procedural and surgical treatment is increasing. Therefore, healthcare personnel should be adequately aware and knowledgeable about radiation hazards to protect themselves and their patients from its adverse effects. The objective of this study was to examine awareness about radiation hazards and knowledge about protection methods among the anesthesia personnel and surgical subspecialists of a quaternary care academic center. Methods: A validated questionnaire was completed by anesthetic personnel and surgical subspecialists. It consisted of questions that required demographic information and assessed awareness about radiation hazards. In addition, 15 multiple-choice questions assessed knowledge about radiation across the following domains: the main principle of radiation protection, personal annual radiation dose, personal protection equipment, safe distance from an X-ray machine, and susceptible organs. Results: A total of 270 potential participants were emailed and invited to respond to an online questionnaire, and the response rate was 79.3%. Of the 214 participants, 69.2% were women; the mean age of the sample was 34.8 years. Most of the participants (63.1%) considered radiation exposure that occurs as a part of daily work to be very harmful; 86.4% and 78.5% reported that they always wore a lead apron and a thyroid shield when working in an environment that entails radiation exposure, respectively. The mean score for knowledge about radiation hazards and protection was 6.4 ± 2.0 (maximum possible score = 15) Therefore, there is a need to improve anesthetic personnel and surgical subspecialists’ knowledge about radiation protection, especially with regard to the use of lead goggles and harmful doses of radiation. Conclusion: The present findings suggest that there is a reasonable level of awareness but a relative lack of knowledge about radiation hazards and protection among anesthesia personnel and surgical subspecialists. Therefore, continuing medical education on radiation hazards and protection must be mandated.
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Affiliation(s)
- Chaowanan Khamtuikrua
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sirilak Suksompong
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Almohiy H. Knowledge and awareness of ionizing radiation risks among Saudi Obstetricians. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2020. [DOI: 10.1080/16878507.2020.1762528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Elshami W, Abuzaid M, Piersson AD, Mira O, AbdelHamid M, Zheng X, Kawooya MG. OCCUPATIONAL DOSE AND RADIATION PROTECTION PRACTICE IN UAE: A RETROSPECTIVE CROSS-SECTIONAL COHORT STUDY (2002-2016). RADIATION PROTECTION DOSIMETRY 2019; 187:426-437. [PMID: 31605126 DOI: 10.1093/rpd/ncz184] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 06/10/2023]
Abstract
A two-phased retrospective cross-sectional study analysed the occupational dose and radiation protection practice among medical workers in two hospitals in the UAE. Phase 1 evaluated radiation protection practice using a questionnaire, whereas phase 2 assessed the occupational dose. Readings of 952 thermoluminescence dosimeters were analyzed. The result showed 52% of medical workers have a good level of radiation protection practice. Readings of 952 thermoluminescence dosimeters were analyzedAverage annual effective dose per worker ranged from 0.39 to 0.83 mSv. Cardiologists and nurses displayed a higher average of occupational radiation dose compared to other workers. There were no significant correlations between radiation protection practice and hospital, occupation or department. Finally, the occupational dose was within the international and national limits, but the reduction of radiation dose to cardiologist and nurses is essential. Moreover, training is essential to promote radiation safe practice among medical workers.
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Affiliation(s)
- Wiam Elshami
- Assistant professor at Medical Diagnostic Imaging Department, University of Sharjah, 27272, Sharjah, United Arab Emirates
| | - Mohamed Abuzaid
- Assistant professor at Medical Diagnostic Imaging Department, University of Sharjah, 27272, Sharjah, United Arab Emirates
| | - Albert D Piersson
- Faculty, Department of Imaging Technology & Sonography, University of Cape Coast, Cape Coast, Ghana
| | - Ola Mira
- Ministry of Health and Prevention, Dubai 1853, United Arab Emirates
| | | | - Xiaoming Zheng
- Charles Sturt University, School of Dentistry and Health, Australia Sciences, Wagga Wagga NSW 2678, Australia
| | - M G Kawooya
- Ernest cook Ultrasound Research and Education Institute (ECUREI) 7161, Kampala, Uganda
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Dauda AM, Ozoh JO, Towobola OA. Medical doctors' awareness of radiation exposure in diagnostic radiology investigations in a South African academic institution. SA J Radiol 2019; 23:1707. [PMID: 31754532 PMCID: PMC6837774 DOI: 10.4102/sajr.v23i1.1707] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 02/12/2019] [Indexed: 12/01/2022] Open
Abstract
Background Diagnostic investigations using radiation have become a critical feature of medical practice in recent times. However, the possibility of doctors’ underestimation of risks of over-exposure of patients to diagnostic radiation still warrants further evaluation. Objectives To investigate doctors’ awareness of diagnostic radiation exposure at Dr George Mukhari Academic Hospital, South Africa. Methods This was a cross-sectional, analytical investigation of the awareness of doctors about radiation exposure in diagnostic radiology investigations. A cluster sampling technique was employed to recruit 217 participants. Consent and approval of the participants were sought and obtained before questionnaire administration during departmental meetings between October 2017 and March 2018. Results Of the participants, 80% had no formal training on radiation exposure and 33.8% of them correctly estimated natural background radiation. Correct estimates of the effective dose from a single-view abdominal X-ray (AXR) were expressed by 7.5%, quantity of radiation of a single-phase computed tomography (CT) abdomen by 30.3% and dosage from a two-view unilateral mammogram by 29.1% of the participants. More than 75% of participants agreed that children are more sensitive to radiation, but only 10.5% suggested medical termination of pregnancy for a woman who had CT abdomen and pelvis with contrast. Dosage and risk of inducing fatal cancer from common but more complex imaging procedures were poorly understood. Only the doctors of the radiology department showed a statistically significant (p < 0.0001) association with regards to their radiation awareness. Conclusion Because of the high rate of poor awareness of radiation risks observed in this study, it is important to initiate, early in the medical curriculum for medical students, the need for a rotation in the Department of Radiology, similar to such rotations in other medical specialties.
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Affiliation(s)
- Akingboye M Dauda
- Department of Diagnostic Radiology and Imaging, Dr George Mukhari Academic Hospital, Ga-Rankuwa, Pretoria, South Africa
| | - John O Ozoh
- Department of Diagnostic Radiology and Imaging, Dr George Mukhari Academic Hospital, Ga-Rankuwa, Pretoria, South Africa
| | - Olakunle A Towobola
- Department of Internal Medicine, School of Medicine, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, South Africa
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Ribeiro A, Husson O, Drey N, Murray I, May K, Thurston J, Oyen W. Ionising radiation exposure from medical imaging - A review of Patient's (un) awareness. Radiography (Lond) 2019; 26:e25-e30. [PMID: 32052780 DOI: 10.1016/j.radi.2019.10.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/26/2019] [Accepted: 10/04/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Medical imaging is the main source of artificial radiation exposure. Evidence, however, suggests that patients are poorly informed about radiation exposure when attending diagnostic scans. This review provides an overview of published literature with a focus on nuclear medicine patients on the level of awareness of radiation exposure from diagnostic imaging. METHODS A review of available literature on awareness, knowledge and perception of ionising radiation in medical imaging was conducted. Articles that met the inclusion criteria were subjected to critical appraisal using the Mixed Methods Appraisal Tool. RESULTS 140 articles identified and screened for eligibility, 24 critically assessed and 4 studies included in synthesis. All studies demonstrated that patients were generally lacking awareness about radiation exposure and highlighted a lack of communication between healthcare professionals and patients with respect to radiation exposure. CONCLUSION Studies demonstrate a need to better inform patients about their radiation exposure, and further studies focusing on nuclear medicine patients are particularly warranted. IMPLICATIONS FOR PRACTICE Adequate and accurate information is crucial to ensure the principle of informed consent is present.
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Affiliation(s)
- A Ribeiro
- The Royal Marsden Hospital NHS Foundation Trust, Sutton, United Kingdom.
| | - O Husson
- Institute of Cancer Research, Sutton, United Kingdom
| | - N Drey
- City University of London, London, United Kingdom
| | - I Murray
- The Royal Marsden Hospital NHS Foundation Trust, Sutton, United Kingdom
| | - K May
- The Royal Marsden Hospital NHS Foundation Trust, Sutton, United Kingdom
| | - J Thurston
- The Royal Marsden Hospital NHS Foundation Trust, Sutton, United Kingdom
| | - W Oyen
- The Royal Marsden Hospital NHS Foundation Trust, Sutton, United Kingdom; Institute of Cancer Research, Sutton, United Kingdom
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Demir MC, Akkas M. Awareness of Risks Associated with the Use of Plain X-Ray, Computed Tomography, and Magnetic Resonance Imaging Among Emergency Physicians and Comparison with that of Other Physicians: A Survey from Turkey. MEDICAL SCIENCE MONITOR : INTERNATIONAL MEDICAL JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019; 25:6587-6597. [PMID: 31476197 PMCID: PMC6738011 DOI: 10.12659/msm.918381] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Increased use of radiological imaging in all departments of medicine, especially in the Emergency Department, requires that physicians have a high level of knowledge regarding commonly used imaging methods and high awareness of the risks of examinations. MATERIAL AND METHODS The physicians were divided into 5 groups according to their specialties as emergency medicine physicians (EMPs), physicians from any specialty of internal sciences, physicians from any specialty of surgical sciences, general practitioners (GPs), and radiologists. A total of 700 physicians answered the questionnaire via email. RESULTS 15.7% of EMPs reported that they did not routinely perform any risk assessment before requesting computed tomography (CT); the rate was 17.9% for direct radiography and 29.3% for magnetic resonance imaging (MRI). The proportions of physicians who do not routinely perform risk assessments for direct radiography, CT, and MRI were as follows: 16.4%, 8.6%, and 19.3% in physicians from medical sciences, respectively; 25%, 22.9%, and 35% in physicians from surgical sciences, respectively; 24.3%, 14.3%, and 37.1% in GPs, respectively; and 27.1%, 22.1% and 37.1% in radiologists, respectively. In all radiological examinations, 1.4% of EMPs and ≤1.4% of other physicians routinely explain the risks associated with the imaging method to the patients, and discuss the risks and benefits of the imaging with the patients. CONCLUSIONS All physicians, including EMPs, need to undergo urgent training to increase their knowledge on risks of imaging methods and discussion of existing risks with patients.
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Affiliation(s)
- Mehmet Cihat Demir
- Department of Emergency Medicine, Sinop Atatürk State Hospital, Sinop, Turkey
| | - Meltem Akkas
- Department of Emergency Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Anderson KT, Bartz-Kurycki MA, Austin MT, Kawaguchi AL, Kao LS, Lally KP, Tsao K. Hospital type predicts computed tomography use for pediatric appendicitis. J Pediatr Surg 2019; 54:723-727. [PMID: 29925468 DOI: 10.1016/j.jpedsurg.2018.05.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/23/2018] [Accepted: 05/23/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Evidence-based guidelines recommend ultrasound (US) over computed tomography (CT) as the primary imaging modality for suspected pediatric appendicitis. Continued high rates of CT use may result in significant unnecessary radiation exposure in children. The purpose of this study was to evaluate variables associated with preoperative CT use in pediatric appendectomy patients. METHODS A retrospective cohort study of pediatric patients who underwent appendectomy for acute appendicitis in 2015-2016 at National Surgical Quality Improvement Program for Pediatrics (NSQIP-P) hospitals was conducted. Pediatric (<18 years old) patients who underwent appendectomy for acute appendicitis in an NSQIP-P hospital from 2015 to 2016 were included. Patients were excluded if they underwent interval or incidental appendectomy or did not have a final diagnosis of appendicitis. Variables associated with imaging evaluation, including age, body mass index (BMI), race/ethnicity, gender and hospital of presentation (NSQIP-P vs. non-NSQIP-P hospital) were evaluated. The primary outcome was receipt of preoperative CT. Secondary outcomes include reimaging practices and trends over time. RESULTS 22,333 children underwent appendectomies, of which almost all were imaged preoperatively (96.5%) and 36% of whom presented initially to a non-NSQIP-P hospital. Overall, US only was the most common imaging modality (52%), followed by CT only (27%), US+CT (16%), no imaging (3%), MRI +/- CT/US (1%) and MRI only (<1%). On regression, older age (>11 years), obesity (BMI >95th percentile for age), and female gender were associated with increased odds of receiving a CT scan. However, initial presentation to a non-NSQIP-P hospital was the strongest predictor of CT use (OR 9.4, 95% CI 8.1-10.8). Reimaging after transfer was common, especially after US and MRI at a non-NSQIP-P hospital. CT use decreased between 2015 and 2016 in non-NSQIP-P hospitals but remained the same (25%) in NSQIP-P facilities. CONCLUSIONS Though patient characteristics were associated with different imaging practices, presentation at a referral, nonchildren's hospital is the strongest predictor of CT use in children with appendicitis. NSQIP-P hospitals frequently reimage transferred patients and have not reduced their CT use. Novel strategies are required for all hospital types in order to sustain reduction in CT use and mitigate unnecessary imaging. LEVEL OF EVIDENCE Level III. TYPE OF STUDY Retrospective comparative study.
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Affiliation(s)
- Kathryn Tinsley Anderson
- McGovern Medical School, University of Texas Health Sciences Center at Houston, Department of Pediatric Surgery, Houston, TX; Center for Surgical Trials and Evidence-Based Practice (C-STEP), Houston, TX.
| | - Marisa A Bartz-Kurycki
- McGovern Medical School, University of Texas Health Sciences Center at Houston, Department of Pediatric Surgery, Houston, TX; Center for Surgical Trials and Evidence-Based Practice (C-STEP), Houston, TX
| | - Mary T Austin
- McGovern Medical School, University of Texas Health Sciences Center at Houston, Department of Pediatric Surgery, Houston, TX; Children's Memorial Hermann Hospital, Houston, TX; Center for Surgical Trials and Evidence-Based Practice (C-STEP), Houston, TX
| | - Akemi L Kawaguchi
- McGovern Medical School, University of Texas Health Sciences Center at Houston, Department of Pediatric Surgery, Houston, TX; Children's Memorial Hermann Hospital, Houston, TX; Center for Surgical Trials and Evidence-Based Practice (C-STEP), Houston, TX
| | - Lillian S Kao
- McGovern Medical School, University of Texas Health Sciences Center at Houston, Department of Pediatric Surgery, Houston, TX; Center for Surgical Trials and Evidence-Based Practice (C-STEP), Houston, TX
| | - Kevin P Lally
- McGovern Medical School, University of Texas Health Sciences Center at Houston, Department of Pediatric Surgery, Houston, TX; Children's Memorial Hermann Hospital, Houston, TX; Center for Surgical Trials and Evidence-Based Practice (C-STEP), Houston, TX
| | - Kuojen Tsao
- McGovern Medical School, University of Texas Health Sciences Center at Houston, Department of Pediatric Surgery, Houston, TX; Children's Memorial Hermann Hospital, Houston, TX; Center for Surgical Trials and Evidence-Based Practice (C-STEP), Houston, TX
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Hollingsworth TD, Duszak R, Vijayasarathi A, Gelbard RB, Mullins ME. Trainee Knowledge of Imaging Appropriateness and Safety: Results of a Series of Surveys From a Large Academic Medical Center. Curr Probl Diagn Radiol 2019; 48:17-21. [DOI: 10.1067/j.cpradiol.2017.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 10/23/2017] [Indexed: 11/22/2022]
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Hayashi S, Takenaka M, Hosono M, Nishida T. Radiation exposure during image-guided endoscopic procedures: The next quality indicator for endoscopic retrograde cholangiopancreatography. World J Clin Cases 2018; 6:1087-1093. [PMID: 30613666 PMCID: PMC6306631 DOI: 10.12998/wjcc.v6.i16.1087] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 10/23/2018] [Accepted: 10/31/2018] [Indexed: 02/05/2023] Open
Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most frequently used image-guided procedures in gastrointestinal endoscopy. Post-ERCP pancreatitis is an important concern, and prophylaxis, cannulation and other related technical procedures have been well documented by endoscopists. In addition, medical radiation exposure is of great concern in the general population because of its rapidly increasing frequency and its potential carcinogenic effects. International organizations and radiological societies have established diagnostic reference levels, which guide proper radiation use and serve as global standards for all procedures that use ionizing radiation. However, data on gastrointestinal fluoroscopic procedures are still lacking because the demand for these procedures has recently increased. In this review, we present the current status of quality indicators for ERCP and the methods for measuring radiation exposure in the clinical setting as the next quality indicator for ERCP. To reduce radiation exposure, knowledge of its adverse effects and the procedures for proper measurement and protection are essential. Additionally, further studies on the factors that affect radiation exposure, exposure management and diagnostic reference levels are necessary. Then, we can discuss how to manage medical radiation use in these complex fluoroscopic procedures. This knowledge will help us to protect not only patients but also endoscopists and medical staff in the fluoroscopy unit.
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Affiliation(s)
- Shiro Hayashi
- Department of Gastroenterology and Internal Medicine, Hayashi Clinic, Osaka, Suita 564-0018, Japan
- Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Toyonaka 560-8565, Japan
| | - Mamoru Takenaka
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Sayama 589-8511, Japan
| | - Makoto Hosono
- Department of Radiology, Kindai University Faculty of Medicine, Osaka, Sayama 589-8511, Japan
| | - Tsutomu Nishida
- Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Toyonaka 560-8565, Japan
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Hayash S, Nishida T, Matsubara T, Osugi N, Sugimoto A, Takahashi K, Mukai K, Nakamatsu D, Yamamoto M, Fukui K, Inada M. Radiation exposure dose and influencing factors during endoscopic retrograde cholangiopancreatography. PLoS One 2018; 13:e0207539. [PMID: 30452477 PMCID: PMC6242372 DOI: 10.1371/journal.pone.0207539] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 11/01/2018] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Various endoscopic procedures under fluoroscopic guidance are being rapidly adopted, and radiation exposure is considered to be increasing. However, there is little concern about this issue in gastroenterology practice. This study aims to evaluate the actual radiation exposure dose (RD) during endoscopic retrograde cholangiopancreatography (ERCP) and the factors affecting the RD. METHODS In this retrospective, single-center cohort study of 1157 consecutive patients who underwent ERCP between October 2012 and February 2017, we analyzed the influences of patient characteristics, procedure time (min), total fluoroscopy time (min), type of processing engine, experience of the endoscopist, and type of disease on the total RD (mGy). RESULTS The median procedure times were 28 min for common bile duct stones (CBDS), 25 min for distal malignant biliary obstruction (MBO), and 30 min for proximal MBO. Similarly, the median fluoroscopy times were 10.3, 8.8, and 13.4 min, and the median RDs were 167, 123, and 242 mGy, respectively. Proximal MBO required significantly longer procedure time and fluoroscopy time and resulted in greater RD than distal MBO (P = 0.0006, <0.0001, <0.0001) and CBDS (P = 0.015, <0.0001, <0.0001). Multiple linear regression showed that distal MBO and a novel processing engine negatively correlate with RD (P = 0.04, <0.0001) and that proximal MBO positively correlates with RD (P = 0.0001). DISCUSSION Procedure time and fluoroscopy time were significantly longer for proximal MBO than for CBDS and distal MBO. The type of disease and processing engine significantly influenced the RD during ERCP.
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Affiliation(s)
- Shiro Hayash
- Department of Gastroenterology and Hepatology, Toyonaka Municipal Hospital, Toyonaka, Japan
- Department of Gastroenterology and Internal Medicine, Hayashi Clinic, Osaka, Suita, Japan
| | - Tsutomu Nishida
- Department of Gastroenterology and Hepatology, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Tokuhiro Matsubara
- Department of Gastroenterology and Hepatology, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Naoto Osugi
- Department of Gastroenterology and Hepatology, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Aya Sugimoto
- Department of Gastroenterology and Hepatology, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Kei Takahashi
- Department of Gastroenterology and Hepatology, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Kaori Mukai
- Department of Gastroenterology and Hepatology, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Dai Nakamatsu
- Department of Gastroenterology and Hepatology, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Masashi Yamamoto
- Department of Gastroenterology and Hepatology, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Koji Fukui
- Department of Gastroenterology and Hepatology, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Masami Inada
- Department of Gastroenterology and Hepatology, Toyonaka Municipal Hospital, Toyonaka, Japan
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Khan MO, Khan MS, Janjua O, Ali A, Hussain S. Knowledge of radiation legislation and radiation exposure in common radiological investigations among final year medical students, foundation doctors, specialist radiology registrars and radiographers at a UK university teaching hospital. BJR Open 2018; 1:20180014. [PMID: 33178910 PMCID: PMC7592403 DOI: 10.1259/bjro.20180014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 10/10/2018] [Accepted: 10/21/2018] [Indexed: 12/02/2022] Open
Abstract
Objective: Junior doctors routinely request radiological investigations for patients. Prior studies have noted that among this group there is a lack of knowledge on radiation legislation and radiation exposure in common radiological investigations. However, no studies have compared this against radiology trainees and radiographers. We compared knowledge of radiation legislation and radiation exposure in common radiological investigations among final year medical students (FYMS), foundation year doctors (FY1, FY2) against specialist radiology trainees (SRT) and radiographers (RG). Methods: A 12-question multiple choice questionnaire (MCQ) was distributed to FYMS, FY1, FY2, SRT and RG at a UK teaching hospital. Questions assessed knowledge of radiation legislation and radiation-dose estimates of common radiological investigations. Mean MCQ scores were compared using one-way ANOVA and Tukey post-test to determine statistical significance (p-value < 0.05). Results: 127 participants were included in the study. Mean scores (%) for FYMS (49.3%), FY1 (52.6%) and FY2 (51.1%) were significantly lower compared to SRT (64.4%) and RG (66.3%) (p-value < 0.05). Mean test scores between FYMS, FY1 and FY2 did not significantly differ (p-value > 0.05). Conclusion: FYMS, FY1 and FY2 knowledge of radiation legislation and radiation exposure in common radiological investigations was poor compared to SRT and RG. Patients require knowledge of radiation risk to provide informed consent as per IRMER regulations, thus we propose formal teaching on the subject matter to promote radiation safety culture among medical undergraduates and postgraduates. Advances in knowledge: First study to compare knowledge of radiation legislation and radiation exposure in common radiological investigations between medical students and junior doctors to radiology trainees and radiographers.
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Affiliation(s)
- Muhammad Omar Khan
- Department of Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Muhammad Saddique Khan
- Department of Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Osman Janjua
- Department of Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Ahmed Ali
- Department of Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Shahid Hussain
- Department of Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
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Macía-Suárez D, Sánchez-Rodríguez E. Conocimientos en materia de radioprotección en radiólogos del noroeste de España. RADIOLOGIA 2018; 60:320-325. [DOI: 10.1016/j.rx.2018.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/13/2018] [Accepted: 01/15/2018] [Indexed: 10/16/2022]
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Macía-Suárez D, Sánchez-Rodríguez E. Radiation protection knowledge among radiologists in northwest Spain. RADIOLOGIA 2018. [DOI: 10.1016/j.rxeng.2018.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Barakat MT, Thosani NC, Huang RJ, Choudhary A, Kochar R, Kothari S, Banerjee S. Effects of a Brief Educational Program on Optimization of Fluoroscopy to Minimize Radiation Exposure During Endoscopic Retrograde Cholangiopancreatography. Clin Gastroenterol Hepatol 2018; 16:550-557. [PMID: 28804031 PMCID: PMC5809234 DOI: 10.1016/j.cgh.2017.08.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 08/02/2017] [Accepted: 08/04/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Fluoroscopy during endoscopic retrograde cholangiopancreatography (ERCP) is increasingly performed by therapeutic endoscopists, many of whom have not received formal training in modulating fluoroscopy use to minimize radiation exposure. Exposure to ionizing radiation has significant health consequences for patients and endoscopists. We aimed to evaluate whether a 20-minute educational intervention for endoscopists would improve use of fluoroscopy and decrease ERCP-associated exposure to radiation for patients. METHODS We collected data from 583 ERCPs, performed in California from June 2010 through November 2012; 331 were performed at baseline and 252 following endoscopist education. The educational intervention comprised a 20-minute video explaining best practices for fluoroscopy, coupled with implementation of a formal fluoroscopy time-out protocol before the ERCP was performed. Our primary outcome was the effect of the educational intervention on direct and surrogate markers of patient radiation exposure associated with ERCPs performed by high-volume endoscopists (HVEs) (200 or more ERCPs/year) vs low-volume endoscopists (LVEs) (fewer than 200 ERCPs/year). RESULTS At baseline, total radiation dose and dose area product were significantly higher for LVEs, but there was no significant difference between HVEs and LVEs following education. Education was associated with significant reductions in median fluoroscopy time (48% reduction for HVEs vs 30% reduction for LVEs), total radiation dose (28% reduction for HVEs vs 52% for LVEs) and dose area product (35% reduction for HVEs vs 48% reduction for LVEs). All endoscopists significantly increased their use of low magnification and collimation following education. CONCLUSIONS A 20-minute educational program with emphasis on ideal use of modifiable fluoroscopy machine settings results in an immediate and significant reduction in ERCP-associated patient radiation exposure for low-volume and high-volume endoscopists. Training programs should consider radiation education for advanced endoscopy fellows.
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Affiliation(s)
- Monique T Barakat
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, California
| | - Nirav C Thosani
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, California
| | - Robert J Huang
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, California
| | - Abhishek Choudhary
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, California
| | - Rajan Kochar
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, California
| | - Shivangi Kothari
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, California
| | - Subhas Banerjee
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, California.
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Kasraie N, Jordan D, Keup C, Westra S. Optimizing Communication With Parents on Benefits and Radiation Risks in Pediatric Imaging. J Am Coll Radiol 2018; 15:809-817. [PMID: 29555251 DOI: 10.1016/j.jacr.2018.01.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/19/2018] [Accepted: 01/23/2018] [Indexed: 01/20/2023]
Abstract
Effective radiation risk communication is a core competency for radiology care providers and can prevent and resolve potential conflicts while helping achieve effective public health safeguards. The authors present a synopsis of the challenges to holding such dialogue and review published methods for strengthening and maintaining this discourse. Twelve strategies are discussed in this article that can help alleviate concerns about the iatrogenic risk associated with medical imaging using radiation exposure.
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Affiliation(s)
- Nima Kasraie
- Children's Mercy Hospital, Kansas City, Missouri.
| | - David Jordan
- University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | | | - Sjirk Westra
- MassGeneral Hospital for Children, Boston, Massachusetts
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Choi MH, Jung SE, Oh SN, Byun JY. Educational Effects of Radiation Reduction During Fluoroscopic Examination of the Adult Gastrointestinal Tract. Acad Radiol 2018; 25:202-208. [PMID: 29129528 DOI: 10.1016/j.acra.2017.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 08/30/2017] [Accepted: 09/06/2017] [Indexed: 02/04/2023]
Abstract
RATIONALE AND OBJECTIVES This study aimed to evaluate the effects of educating radiology residents and radiographers about radiation exposure on reduction of dose area product (DAP) and fluoroscopy time in diagnostic fluoroscopy of the gastrointestinal (GI) tract in adult patients. MATERIALS AND METHODS In April 2015, we offered 1 hour of education to radiology residents and radiographers on how to reduce radiation doses during fluoroscopic examinations. Fluoroscopic examinations of the GI tracts of adult patients performed from June 2014 to February 2016 were evaluated. A total of 2326 fluoroscopic examinations (779 and 1547 examinations before and after education, respectively) were performed, including 10 kinds of examinations. Fluoroscopy time and DAP were collected. A radiologist evaluated the number of spot images, captured images, cine video, captured video, and the use of collimation or magnification. We used the Mann-Whitney U test to assess the difference in fluoroscopy-related factors before and after education. RESULTS Median DAP decreased significantly after education, from 21.1 to 18.2 Gy∙cm2 (P < .001) in all examinations. After education DAP decreased significantly in defecography (P < .001) and fluoroscopy time decreased significantly in upper gastrointestinal series with water-soluble contrast (P < .001). Spot and cine images that increased the radiation dose were used less frequently after education than before in some kinds of examinations, especially in defecography (P < .001). More images were collimated after education in barium swallow than before (P < .001). CONCLUSIONS Educating radiologist residents and radiographers could reduce DAP in fluoroscopy examinations of the GI tract in adult patients.
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Kada S. Awareness and knowledge of radiation dose and associated risks among final year medical students in Norway. Insights Imaging 2017; 8:599-605. [PMID: 28952058 PMCID: PMC5707217 DOI: 10.1007/s13244-017-0569-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 08/07/2017] [Accepted: 08/11/2017] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES The objective was to assess the knowledge of radiation dose and of the associated risks with ionising imaging examinations of medical students in their final year of training prior to graduating. METHODS An online questionnaire was sent to all final year medical students from two universities. The questionnaire consisted of radiation dose and risk related questions, with multiple choices, only one of these choices was the correct answer. A 'correct' answer was given one mark and no mark was given for 'incorrect/do not know' answers. The total mean score ranged from 0 to 11, with higher scores representing greater knowledge about radiation doses and the associated risks. RESULTS Ninety-nine students completed and returned the questionnaire yielding a response rate of 45%. The total mean score was 3.91 out of possible 11. Only eighteen students scored more than five points (50%). Students who reported moderate confidence in their knowledge about radiation dose and risks, scored significantly higher than students who reported no confidence (p = 0.003). There was a moderate positive correlation between students that reported moderate confidence and radiation knowledge scores (rho = .301, p = .002). CONCLUSION Overall medical students' knowledge of radiation dose and the risks associated with ionising imaging examinations was reported to be low. MAIN MESSAGES • Medical students' knowledge about radiation and associated risk is poor • Students are not aware of radiation doses for common radiological procedures • The majority of students underestimated radiation doses for specific examinations • Students with confidence reported greater knowledge than students with no confidence.
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Affiliation(s)
- Sundaran Kada
- Department of Occupational therapy, Physiotherapy and Radiography, Western Norway University of Applied Sciences, Postbox 7030, 5020, Bergen, Norway.
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Practices and attitudes towards radiation risk disclosure for computed tomography: survey of emergency medicine residency program directors. Emerg Radiol 2017; 24:479-486. [DOI: 10.1007/s10140-017-1493-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/02/2017] [Indexed: 10/19/2022]
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Newman S. Informing Patients About the Cancer Induction Risk of Undergoing Computed Tomography Imaging: The Radiographers' Perspective. J Med Imaging Radiat Sci 2016; 47:337-348. [DOI: 10.1016/j.jmir.2016.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 07/19/2016] [Accepted: 07/19/2016] [Indexed: 01/04/2023]
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JOURNAL CLUB: Scatter Radiation Dose From Digital Screening Mammography Measured in a Representative Patient Population. AJR Am J Roentgenol 2016; 206:359-64; quiz 365. [PMID: 26797364 DOI: 10.2214/ajr.15.14921] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to quantify the amount of scatter radiation received at the skin surface overlying the thyroid gland, salivary gland, lens of the eye, sternum, and uterus during a routine screening digital mammographic examination measured in a representative patient population. SUBJECTS AND METHODS The subjects were 207 women without symptoms with varied body mass indexes who underwent annual screening mammography while wearing six optically stimulated luminescence dosimeters placed at the bridge of the nose, right submandibular gland, right and left thyroid lobes, mid sternum, and 2 cm caudal to the umbilicus to assess scatter radiation dose to the skin. RESULTS The average scatter radiation doses at the skin surface during digital screening mammography in the representative population of women were as follows: overlying the right lobe of the thyroid, 0.24 mGy; left lobe of the thyroid, 0.25 mGy; salivary gland, 0.2 mGy; bridge of the nose, 0.025 mGy; sternum, 0.87 mGy; and umbilicus, 0.011 mGy. The scatter radiation doses at the umbilicus and the bridge of the nose were too low to measure with statistical confidence. Scatter radiation dose increased with increasing body mass index and increasing breast compression thickness. CONCLUSION Scatter radiation dose at the skin overlying organs of interest is a small fraction of the entrance skin dose to the breast. The low levels of scatter radiation measured do not support delaying clinically indicated mammography during early pregnancy.
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Ditkofsky N, Shekhani HN, Cloutier M, Chen ZN, Zhang C, Hanna TN. Ionizing Radiation Knowledge Among Emergency Department Providers. J Am Coll Radiol 2016; 13:1044-1049.e1. [PMID: 27162040 DOI: 10.1016/j.jacr.2016.03.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 02/29/2016] [Accepted: 03/07/2016] [Indexed: 01/12/2023]
Abstract
PURPOSE The aim of this study was to assess knowledge of ionizing radiation exposure from diagnostic imaging examinations among emergency department (ED) providers. METHODS An electronic questionnaire was distributed to ED providers in a five-hospital university-affiliated health care system. Providers included attending emergency medicine (EM) physicians, EM residents, and midlevel providers (MLPs) (nurse practitioners and physicians assistants). Data were collected and analyzed. RESULTS One hundred six of 210 providers (41 attending physicians, 32 residents, and 31 MLPs) completed the survey, for a response rate of 50.5%. More than two in five providers (44.6%) could not correctly identify which of six common imaging modalities used ionizing radiation. MLPs were more likely to incorrectly identify radiography (25%) and fluoroscopy (29%) as modalities that did not use ionizing radiation (P = .01 and P = .25 respectively). Fewer attending physicians (14.6%) than residents (37.5%) were not very comfortable or were uncomfortable explaining the risks of radiation to patients. Nearly half of attending physicians (47.5%) and nearly three-quarters of residents (71.9%) were not very comfortable, were uncomfortable, or were extremely uncomfortable explaining the amount of radiation in certain imaging tests to patients. MLPs were more likely to incorrectly rank a selection of imaging tests by radiation exposure (P = .002). MLPs were more likely to incorrectly answer a question on the effects of ionizing radiation on patients (P = .01). CONCLUSIONS Among ED providers, there are knowledge gaps regarding the presence and effect of ionizing radiation in diagnostic imaging tests. MLPs were more likely to make factual errors, while EM residents were least comfortable counseling patients about radiation risks.
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Affiliation(s)
- Noah Ditkofsky
- Department of Radiology, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada
| | - Haris N Shekhani
- Division of Emergency Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Megan Cloutier
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Zhengjia Nelson Chen
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Chao Zhang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Tarek N Hanna
- Division of Emergency Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
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Jindal T. The Knowledge of Radiation and the Attitude Towards Radio-Protection among Urology Residents in India. J Clin Diagn Res 2016; 9:JC08-11. [PMID: 26816919 DOI: 10.7860/jcdr/2015/14004.6968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 09/03/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Exposure to radiation is a hazard and precautions are necessary to limit it. This study was done to assess the knowledge of radiation and the attitude towards radio-protection among urology residents in India. MATERIALS AND METHODS A questionnaire was administered to assess the knowledge and attitude of urology residents who came from all over the country to attend a clinical meeting at Apollo Gleneagles Hospital, Kolkata, India. RESULTS All the respondents agreed to being exposed to radiation, with 78.2% using radiation in more than five cases a week. Only 65.2% always took some steps for radio-protection. Lead aprons and thyroid shields were the most common radiation protection devices used. None of the residents ever used lead gloves or protective eye glasses or dosimeters. An 82.6% felt that they did not have adequate knowledge, 85.4% of residents did not receive any formal classes regarding the risk of radiation, 21.7% either rarely or never moved out of the operating room when the radiation was being used, 42.4% did not know that the SI unit of the equivalent absorbed dose of radiation & 52.1% did not know about the amount of radiation delivered to an adult during a contrast enhanced CT scan of the abdomen. CONCLUSION Results of the present study reveal that the urology residents of India lack knowledge about the risks of radiation exposure. Majority of them did not take necessary precautions to limit their exposure to radiation.
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Affiliation(s)
- Tarun Jindal
- Consultant, Department of Urology, SSTC , Firozabad, India
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Sheng AY, Breaud AH, Schneider JI, Kadom N, Mitchell PM, Linden JA. Interactive Learning Module Improves Resident Knowledge of Risks of Ionizing Radiation Exposure From Medical Imaging. Curr Probl Diagn Radiol 2015; 45:258-64. [PMID: 26657346 DOI: 10.1067/j.cpradiol.2015.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 11/04/2015] [Indexed: 12/23/2022]
Abstract
Physician awareness of the risks of ionizing radiation exposure related to medical imaging is poor. Effective educational interventions informing physicians of such risk, especially in emergency medicine (EM), are lacking. The SIEVERT (Suboptimal Ionizing Radiation Exposure Education - A Void in Emergency Medicine Residency Training) learning module was designed to improve provider knowledge of the risks of radiation exposure from medical imaging and comfort in communicating these risks to patients. The 1-hour module consists of introductory lecture, interactive discussion, and role-playing scenarios. In this pilot study, we assessed the educational effect using unmatched, anonymous preintervention and postintervention questionnaires that assessed fund of knowledge, participant self-reported imaging ordering practices in several clinical scenarios, and trainee comfort level in discussing radiation risks with patients. All 25 EM resident participants completed the preintervention questionnaire, and 22 completed the postintervention questionnaire within 4 hours after participation. Correct responses on the 14-question learning assessment increased from 6.32 (standard deviation = 2.36) preintervention to 12.23 (standard deviation = 1.85) post-intervention. Overall, 24% of residents were comfortable with discussing the risks of ionizing radiation exposure with patients preintervention, whereas 41% felt comfortable postintervention. Participants ordered fewer computed tomography scans in 2 of the 4 clinical scenarios after attending the educational intervention. There was improvement in EM residents' knowledge regarding the risks of ionizing radiation exposure from medical imaging, and increased participant self-reported comfort levels in the discussion of these risks with patients after the 1-hour SIEVERT learning module.
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Affiliation(s)
- Alexander Y Sheng
- Department of Emergency Medicine, Boston University Medical Center, Boston, MA.
| | - Alan H Breaud
- Department of Emergency Medicine, Boston University Medical Center, Boston, MA
| | - Jeffrey I Schneider
- Department of Emergency Medicine, Boston University Medical Center, Boston, MA
| | - Nadja Kadom
- Department of Radiology, Boston University Medical Center, Boston, MA
| | - Patricia M Mitchell
- Department of Emergency Medicine, Boston University Medical Center, Boston, MA
| | - Judith A Linden
- Department of Emergency Medicine, Boston University Medical Center, Boston, MA
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Kozak B, Webb EM, Khan BK, Orozco NM, Straus CM, Naeger DM. Medical Student Usage of the American College of Radiology Appropriateness Criteria. Acad Radiol 2015; 22:1606-11. [PMID: 26854303 DOI: 10.1016/j.acra.2015.08.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
RATIONALE AND OBJECTIVES Educating medical students on appropriate imaging utilization has been increasingly recognized as important for patient care. The American College of Radiology Appropriateness Criteria (ACR-AC) is designed to support evidence-based imaging examination selection. We sought to assess whether medical students order imaging studies independently, what resources they use for guidance, and whether they use the ACR-AC in clinical practice. A secondary aim was to determine whether increasing familiarity with the ACR-AC could impact student usage. MATERIALS AND METHODS We surveyed third year medical students at a single institution on their imaging practices, familiarity with the ACR-AC, and preferences among available resources to guide proper examination selection. The survey was performed in person before a lecture. We also designed a brief intervention to improve familiarity with the ACR-AC and then reassessed students to determine any effect on utilization. RESULTS The response rate for the initial survey was 103 of 109 (94%) and the response rate for the second survey was 99 of 109 (91%).Our initial survey found students initiated imaging orders independently (74 of 100, 74.8%) and consulted resources to assist in examination selection (50 of 74, 67.6%). Students expressed a preference for non-ACR-AC resources, notably Up to Date via its online mobile application.Few students (8 of 71, 11.3%) were familiar with the ACR-AC. After an intervention to increase familiarity with the ACR-AC, student awareness of the ACR-AC increased to 61 of 74 (82.4%). However, usage among those familiar with the resource remained low, 13 of 61(21.3%) versus 3 of 8 (37.5%). CONCLUSIONS Use of the ACR-AC was low among third year medical students. After increasing students' familiarity with the ACR-AC, their usage in a clinical setting did not increase. The largest barrier to use may be the lack of a quick, easy to use online mobile application-based interface.
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Thornton RH, Dauer LT, Shuk E, Bylund CL, Banerjee SC, Maloney E, Fox LB, Beattie CM, Hricak H, Hay J. Patient perspectives and preferences for communication of medical imaging risks in a cancer care setting. Radiology 2015; 275:545-52. [PMID: 25803490 DOI: 10.1148/radiol.15132905] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE To identify opportunities for improving patient-centered communication about diagnostic imaging tests that involve the use of radiation in a cancer care setting. MATERIALS AND METHODS Institutional review board approval and informed consent were obtained for this HIPAA-compliant study. Patient knowledge, information sources, and communication preferences were assessed in six focus groups during 2012. The groups consisted of patients undergoing treatment for metastatic colorectal carcinoma, women treated within the past 6 months for early-stage breast carcinoma, men undergoing surveillance after testicular cancer treatment, parents of patients treated for stage I-III neuroblastoma, patients in a thoracic oncology survivorship program, and participants in a lung cancer screening program. A multidisciplinary research team performed thematic content analysis of focus group transcripts. High-level findings were summarized during consensus conferences. RESULTS Although they were aware of the long-term risk of cancer from exposure to ionizing radiation, most participants reported that their health care provider did not initiate discussion about benefits and risks of radiation from imaging tests. Most patients obtained information by means of self-directed internet searches. Participants expressed gratitude for tests ("That CT saved my daughter's life," "I'd rather have the radiation dosage than being opened up"), yet they expressed concern about having to initiate discussions ("If you don't ask, nobody is going to tell you anything") and the desire to be offered information concerning the rationale for ordering specific imaging examinations, intervals for follow-up imaging, and testing alternatives. Participants believed that such information should be available routinely and that conversation with their personal physician or endorsed, readily available reference materials were ideal methods for information exchange. Understanding imaging radiation risks and active participation in decision making about imaging were especially important to cancer survivors. CONCLUSION A substantial gap exists between patient expectations and current practices for providing information about medical imaging tests that involve the use of radiation.
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Affiliation(s)
- Raymond H Thornton
- From the Departments of Radiology (R.H.T., L.T.D., L.B.F., C.M.B., H.H.), Medical Physics (L.T.D.), and Psychiatry and Behavioral Sciences (E.S., C.L.B., S.C.B., E.M., J.H.), Memorial Sloan Kettering Cancer Center, 1275 York Ave, Suite H118, New York, NY 10065
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Medical Radiation Knowledge among Patients in Local Hospitals. J Med Imaging Radiat Sci 2015; 46:45-49. [DOI: 10.1016/j.jmir.2014.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 08/19/2014] [Accepted: 09/04/2014] [Indexed: 12/17/2022]
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Abdellah RF, Attia SA, Fouad AM, Abdel-Halim AW. Assessment of Physicians’ Knowledge, Attitude and Practices of Radiation Safety at Suez Canal University Hospital, Egypt. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/ojrad.2015.54034] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Radiation awareness among radiology residents, technologists, fellows and staff: where do we stand? Insights Imaging 2014; 6:133-9. [PMID: 25412827 PMCID: PMC4330233 DOI: 10.1007/s13244-014-0365-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 10/20/2014] [Accepted: 10/27/2014] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To investigate and compare the knowledge of radiation dose and risk incurred in common radiology examinations among radiology residents, fellows, staff radiologists and technologists. METHODS A questionnaire containing 17 multiple choice questions was administered to all residents, technologists, fellows and staff radiologists of the department of medical imaging through the hospital group mailing list. RESULTS A total of 92 responses was received. Mean score was 8.5 out of 17. Only 48 % of all participants scored more than 50 % correct answers. Only 23 % were aware of dose from both single-view and two-view chest X-ray; 50-70 % underestimated dose from common studies; 50-75 % underestimated the risk of fatal cancer. Awareness about radiation exposure in pregnancy is variable and particularly poor among technologists. A statistically significant comparative knowledge gap was found among technologists. CONCLUSIONS Our results show a variable level of knowledge about radiation dose and risk among radiology residents, fellows, staff radiologists and technologists, but overall knowledge is inadequate in all groups. There is significant underestimation of dosage and cancer risk from common examinations, which could potentially lead to suboptimal risk assessment and excessive or unwarranted studies posing significant radiation hazard to the patient and radiology workers. MAIN MESSAGES • Knowledge of radiation dose and risk is poor among all radiology workers. • Significant knowledge gap among technologists compared to residents, fellows and staff radiologists. • Significant underestimation of radiation dose and cancer risk from common examinations.
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Radiation safety knowledge and perceptions among residents: a potential improvement opportunity for graduate medical education in the United States. Acad Radiol 2014; 21:869-78. [PMID: 24713540 DOI: 10.1016/j.acra.2014.01.016] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 01/15/2014] [Accepted: 01/15/2014] [Indexed: 12/24/2022]
Abstract
RATIONALE AND OBJECTIVES To investigate residents' knowledge of adverse effects of ionizing radiation, frequency of their education on radiation safety, and their use of radioprotective equipment. MATERIALS AND METHODS Residents from 15/16 residency programs at Emory University were asked to complete a resident radiation safety survey through SurveyMonkey(®). The associations between the residents' knowledge and use of radioprotective equipment with residents' specialty and year of training were investigated. RESULTS Response rate was 32.5% (173/532 residents). Thirty-nine percent residents reported radiation safety is discussed in their residency curriculum at least every 6 months. Ninety-five percent believed in a link between radiation exposure and development of cancer. Overall and Radiology residents' knowledge about specific estimated dose effects (correct responses) was limited: radiation dose associated with fetus brain malformation in pregnancy (10% vs. 26%), risk of developing cataract in interventional personnel (27% vs. 47%), lifetime risk of cancer mortality from a single abdominal computed tomography (CT) in children (22% vs. 29%), greater radiosensitivity of children compared to adults (35% vs. 50%), and relative radiation dose from an abdominal CT compared to a chest x-ray (51% vs. 48%). Radiology residents had modestly higher knowledge. There was no significant difference in residents' knowledge across their postgraduate training years. Use of lead thyroid shields was reported by 86% (97% radiology vs. 80% nonradiology; P = .03) and radiation-monitoring badges in 39% (68% radiology vs. 15% nonradiology; P < .001) of the residents. CONCLUSIONS Although radiology residents scored higher, knowledge of radiation safety for patients and healthcare workers is limited among residents regardless of medical specialty. These findings emphasize the need for educational initiatives.
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Qiao Y, Wang N, Chen R, Liang Y. Societal and Individual Determinants of Patients' Radiation Safety Behavior: A Preliminary Investigation from China. J Am Coll Radiol 2014; 11:521-6. [DOI: 10.1016/j.jacr.2013.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 10/16/2013] [Indexed: 10/25/2022]
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Interventional radiology in the pregnant patient for obstetric and nonobstetric indications. Curr Opin Anaesthesiol 2013; 26:450-5. [DOI: 10.1097/aco.0b013e3283625e89] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Event-based versus process-based informed consent to address scientific evidence and uncertainties in ionising medical imaging. Insights Imaging 2013; 4:647-53. [PMID: 23904249 PMCID: PMC3781253 DOI: 10.1007/s13244-013-0272-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 06/19/2013] [Accepted: 06/27/2013] [Indexed: 12/20/2022] Open
Abstract
Background Inappropriate ionising medical imaging has been escalating in the last decades. This trend leads to potential damage to health and has been associated to bioethical and legal issues of patient autonomy. Methods While the doctrine underlines the importance of using informed consent to improve patient autonomy and physician-patient communication, some researchers have argued that it often falls short of this aim. There are basically two different informed consent practices. The first — the so-called “event-based model” — regards informed consent as a passive signature of a standard unreadable template, performed only once in each medical pathway. The second — the so-called “process-based model” — integrates information into the continuing dialogue between physician and patient, vital for diagnosis and treatment. Results Current medical behaviour often embraces the event-based model, which is considered ineffective and contributes to inappropriateness. We sought, in this review, to analyse from juridical and communication standpoints whether process-based informed consent can deal with scientific uncertainties in radiological decision-making. The informed consent is still a distinctive process in defence of both patients’ and physicians’ health and dignity in rule-of-law states and consequently in curtailing the abuse of ionising medical radiation. Main Messages • Inappropriate ionising medical imaging is widespread and increasing worldwide. • This trend leads to noteworthy damage to health and is linked to the issue of patient autonomy. • Some authors have argued that informed consent often falls short of improving patient autonomy. • Process-based informed consent can deal with scientific uncertainties to contrast inappropriateness. • Informed consent is still a distinctive process in defence of both patients and physicians.
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Marwick TH, Chandrashekhar Y, Narula J. Informed Consent and AUC: Bare It All…. JACC Cardiovasc Imaging 2012; 5:665-7. [DOI: 10.1016/j.jcmg.2012.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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