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Lahav Z, Shimonovich S, Kanani F, Haberman S, Ebril S, Hashavia E, Shopen N, Cohen N. Assessing the role of chest CT in minor blunt trauma: evaluation of the NEXUS decision instrument across an expanded population. Eur J Trauma Emerg Surg 2025; 51:84. [PMID: 39869184 DOI: 10.1007/s00068-024-02692-8] [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: 09/16/2024] [Accepted: 11/16/2024] [Indexed: 01/28/2025]
Abstract
OBJECTIVE To evaluate the NEXUS Chest CT ALL decision instrument (DI) in reducing unnecessary chest CT imaging in minor blunt trauma patients while preserving high sensitivity for detecting clinically meaningful injuries. Additionally, we examined the impact of delayed presentation, chronic disease, and anticoagulation/anti-aggregation medications on trauma outcomes. METHODS This retrospective study included 853 adult minor blunt trauma patients who underwent chest CT in the emergency department (ED) of Tel-Aviv Sourasky Medical Center between 2018 and 2022. Clinically meaningful outcomes were defined as trauma-related interventions or hospital admissions. The NEXUS Chest CT DI criteria, along with three additional criteria, were analyzed using logistic regression to identify independent predictors for the primary outcome. These predictors formed a modified DI, and its performance was compared to the original NEXUS DI. RESULTS Among 853 patients (median age 44.5 years, 64.2% male), 230 (27.0%) had trauma-related chest CT findings, and 64 (7.5%) experienced clinically meaningful outcomes. Independent predictors included abnormal chest X-ray (aOR 6.5, p < 0.001), chronic disease (aOR 5.2, p < 0.001), sternal tenderness (aOR 4.7, p = 0.007), rapid deceleration (aOR 3.7, p < 0.001), and chest wall tenderness (aOR 3.1, p < 0.001). The NEXUS DI achieved 92.1% sensitivity, reducing imaging by 41.3%, while the modified DI increased sensitivity to 98.4% with a 34.3% imaging reduction. CONCLUSIONS The NEXUS Chest CT ALL DI significantly reduces unnecessary imaging while maintaining high diagnostic precision. A modified version enhances sensitivity, refining decision-making in emergency care. Integrating such decision tools, particularly in cases of minor trauma, is highly recommended to optimize resource use and improve patient outcomes.
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Affiliation(s)
- Ziv Lahav
- Emergency Department, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel
- The Faculty of Medicine and Health Science, Tel Aviv University, Tel Aviv, Israel
| | - Shachar Shimonovich
- Division of Trauma, Department of Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- The Faculty of Medicine and Health Science, Tel Aviv University, Tel Aviv, Israel
| | - Fahim Kanani
- Division of Trauma, Department of Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- The Faculty of Medicine and Health Science, Tel Aviv University, Tel Aviv, Israel
| | - Shira Haberman
- The Faculty of Medicine and Health Science, Tel Aviv University, Tel Aviv, Israel
| | - Sivan Ebril
- Emergency Department, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel
- The Faculty of Medicine and Health Science, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Hashavia
- Division of Trauma, Department of Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- The Faculty of Medicine and Health Science, Tel Aviv University, Tel Aviv, Israel
| | - Noaa Shopen
- Emergency Department, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel
- The Faculty of Medicine and Health Science, Tel Aviv University, Tel Aviv, Israel
| | - Neta Cohen
- Emergency Department, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel.
- The Faculty of Medicine and Health Science, Tel Aviv University, Tel Aviv, Israel.
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Alrasheed AA, Alammar AM. Exploring Patient Preferences for Information About CT Radiation Exposure: Bridging the Gap Between Patient Preference and Physician Practice. Patient Prefer Adherence 2024; 18:1929-1938. [PMID: 39318368 PMCID: PMC11420885 DOI: 10.2147/ppa.s466115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 09/14/2024] [Indexed: 09/26/2024] Open
Abstract
Background CT scan utilizes ionizing radiation poses a danger to the patient's health. Thus, telling the patient about ionizing radiation would be critical in promoting shared decision-making and improving patient-doctor communication. However, few studies have examined this topic broadly. Objective The study was conducted to identify the frequency of physicians informing patients about the radiation risk before ordering a CT scan, as well as to examine the association between patients' demographic characteristics and their awareness of the radiation risks associated with CT scans. Methods A cross-sectional study was conducted among 387 patients who had undergone CT scans at a tertiary hospital in Riyadh, Saudi Arabia. Data were collected via phone interviews using a structured questionnaire. Chi-squared tests were employed to assess associations between patients' demographic characteristics and their awareness of CT scan radiation risks. Results When examining knowledge, 58% of patients knew that CT involves harmful radiation. This knowledge was significantly associated with higher education level and previous experience with CT scans. Regarding doctors' practice of providing information to patients about the scan, 344 (88.9%) patients indicated that their doctor had explained to them why they needed the scan. Only 28 (7.2%) patients stated that their doctor had mentioned the amount of radiation, and 74 (19.1%) patients indicated that doctors mentioned the risks associated with the radiation of the scan. Almost all patients (96.9%) preferred to be told about why they needed a CT scan. Conclusion The vast majority of patients who underwent CT scans did not receive enough information about the harm of the scans. However, most of them preferred to know about this harm.
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Affiliation(s)
- Abdullah A Alrasheed
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman M Alammar
- King Saud University, King Saud University Medical City, Family and Community Medicine department, Riyadh, Saudi Arabia
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Güven S, Tokas T, Tozsin A, Haid B, Lendvay TS, Silay S, Mohan VC, Cansino JR, Saulat S, Straub M, Tur AB, Akgül B, Samotyjek J, Lusuardi L, Ferretti S, Cavdar OF, Ortner G, Sultan S, Choong S, Micali S, Saltirov I, Sezer A, Netsch C, de Lorenzis E, Cakir OO, Zeng G, Gozen AS, Bianchi G, Jurkiewicz B, Knoll T, Rassweiler J, Ahmed K, Sarica K. Consensus statement addressing controversies and guidelines on pediatric urolithiasis. World J Urol 2024; 42:473. [PMID: 39110242 PMCID: PMC11306500 DOI: 10.1007/s00345-024-05161-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 07/05/2024] [Indexed: 08/10/2024] Open
Abstract
PURPOSE We aimed to investigate controversial pediatric urolithiasis issues systematically, integrating expert consensus and comprehensive guidelines reviews. METHODS Two semi-structured online focus group meetings were conducted to discuss the study's need and content, review current literature, and prepare the initial survey. Data were collected through surveys and focus group discussions. Existing guidelines were reviewed, and a second survey was conducted using the Delphi method to validate findings and facilitate consensus. The primary outcome measures investigated controversial issues, integrating expert consensus and guideline reviews. RESULTS Experts from 15 countries participated, including 20 with 16+ years of experience, 2 with 11-15 years, and 4 with 6-10 years. The initial survey identified nine main themes, emphasizing the need for standardized diagnostic and treatment protocols and tailored treatments. Inter-rater reliability was high, with controversies in treatment approaches (score 4.6, 92% agreement), follow-up protocols (score 4.8, 100% agreement), and diagnostic criteria (score 4.6, 92% agreement). The second survey underscored the critical need for consensus on identification, diagnostic criteria (score 4.6, 92% agreement), and standardized follow-up protocols (score 4.8, 100% agreement). CONCLUSION The importance of personalized treatment in pediatric urolithiasis is clear. Prioritizing low-radiation diagnostic tools, effectively managing residual stone fragments, and standardized follow-up protocols are crucial for improving patient outcomes. Integrating new technologies while ensuring safety and reliability is also essential. Harmonizing guidelines across regions can provide consistent and effective management. Future efforts should focus on collaborative research, specialized training, and the integration of new technologies in treatment protocols.
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Affiliation(s)
- S Güven
- Department of Urology, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey.
| | - T Tokas
- Department of Urology, University General Hospital of Heraklion, Athens, Greece
| | - A Tozsin
- Department of Urology, Trakya University School of Medicine Hospital, Edirne, Turkey
| | - B Haid
- Ordensklinikum Linz, Barmherzige Scwestern Hospital, Linz, Austria
| | - T S Lendvay
- Department of Urology, University of Washington, Seattle Children's Hospital, Seattle, WA, USA
| | - S Silay
- Istanbul Medipol University, Istanbul, Turkey
| | - V C Mohan
- Preeti Urology Hospital, Hyderabad, Telangana, India
| | - J R Cansino
- Hospital Universitario La Paz, Madrid, Spain
| | - S Saulat
- Department of Urology, Tabba Kidney Institute, Karachi, Pakistan
| | - M Straub
- Department of Urology, Technical University Munich, Munich, Germany
| | - A Bujons Tur
- Urology Department, Fundación Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - B Akgül
- Department of Urology, Trakya University School of Medicine Hospital, Edirne, Turkey
| | - J Samotyjek
- Pediatric Surgery and Urology Clinic CMKP in Dziekanów Leśny, Dziekanów Leśny, Poland
| | - L Lusuardi
- Department of Urology, Paracelsus Medical University Salzburg University Hospital, Urology, Salzburg, Austria
| | - S Ferretti
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - O F Cavdar
- Department of Urology, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey
| | - G Ortner
- Department of Urology, General Hospital Hall I.T, Tirol, Austria
| | - S Sultan
- Department of Urology, Menoufia University Hospitals, Shebeen El Kom, Egypt
| | - S Choong
- Institute of Urology, University College Hospital, London, UK
| | - S Micali
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - I Saltirov
- Department of Urology and Nephrology at Military Medical Academy, Sofia, Bulgaria
| | - A Sezer
- Pediatric Urology Clinic, Konya City Hospital, Konya, Turkey
| | - C Netsch
- Asklepios Klinik BarmbekAbteilung Für Urologie, Hamburg, Germany
| | - E de Lorenzis
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - O O Cakir
- King's College London, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, UK
| | - G Zeng
- Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - A S Gozen
- Department of Urology, Medius Clinic, Ostfildern, Germany
| | - G Bianchi
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - B Jurkiewicz
- Pediatric Surgery and Urology Clinic CMKP in Dziekanów Leśny, Dziekanów Leśny, Poland
| | - T Knoll
- Klinikum Sindelfingen-Boeblingen, Sindelfingen, Germany
| | - J Rassweiler
- Department of Urology and Andrology, Danube Private University, Krems, Austria
| | - K Ahmed
- King's College London, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, UK
- Sheikh Khalifa Medical City, Abu Dhabi, UAE
- Khalifa University, Abu Dhabi, UAE
| | - K Sarica
- Sancaktepe Sehit Prof. Dr. Ilhan Varank Research and Training Hospital, Istanbul, Turkey
- Department of Urology, Biruni University Medical School, Istanbul, Turkey
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Mellis S, Zhang Y, McAteer D. Awareness of radiation risks by medical students & referrers requesting radiological examinations in the North of Scotland: an audit. BMC MEDICAL EDUCATION 2024; 24:830. [PMID: 39090574 PMCID: PMC11295379 DOI: 10.1186/s12909-024-05461-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 04/23/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION Radiological imaging has played an important role in diagnostic medicine for over a century, though it is known to contribute to dermatological conditions, cataracts, and cancer. The associated risk of harm has led to the introduction of protective regulations around the world. Present-day NHS clinicians are increasingly requesting and relying on diagnostic imaging. Knowledge surrounding the radiation doses of common radiological investigations and the associated risks is imperative, and on a global level has been found to be inadequate. Consequently, there is a need for the formal inclusion of teaching within training programmes. AIMS/OBJECTIVES This prospective audit aims to establish the knowledge of radiation doses and risks of common radiological investigations of both medical students and referrers within four NHS Health Boards based in the North of Scotland. It also seeks to establish prior teaching and the preference for further educational interventions. AUDIT STANDARD Referrers should have adequate knowledge of radiation doses and the risks associated with common radiological investigations. AUDIT TARGET The standard should be achieved by 90% of referrers. METHODS A 19-question online survey was devised to include subjective and objective questions on ionising radiation awareness, education preference, and respondent demographics, based on RCR (Royal College of Radiologists) audit criteria and previous studies. Data collection was conducted between the 22/02/23 to the 22/03/2023 and the questionnaire was distributed to senior medical students and radiological referrers of different grades within NHS Grampian, NHS Highland, NHS Shetland, and NHS Orkney. A descriptive analysis of the data was undertaken using Microsoft Excel Version 16.71. RESULTS Two hundred eight questionnaires were completed. 22.11% (n = 46) of the sample population had received no prior teaching on the topic of ionising radiation. Over half of the respondents (51.92%, n = 108) rated the importance of radiation risks as either important or extremely important, with 69.71% (n = 145) of participants rating their perceived knowledge as limited or average. Most correctly identified that a CT scan (n = 203), PET-CT scan (n = 199) and a chest x-ray (n = 196) exposed patients to ionising radiation. A small proportion of the participants incorrectly thought that an MRI scan (n = 21) and an ultrasound scan (n = 2) involved ionising radiation. The results obtained failed to meet the RCR audit target, which states that 90% of doctors should be aware of common radiological doses. It was observed that only 17.79% (n = 37) of survey respondents scored over 50% in the knowledge assessment, with the median knowledge score of the whole cohort being 2.5 out of 9 (27.78%). Respondents who had prior teaching on the topic performed better those who had no prior teaching, with average scores of 3.19 (35.44%) and 2.04 (22.67%) respectively. Senior clinicians performed better when compared to junior clinicians and medical students. CONCLUSION & FUTURE RECOMMENDATIONS This audit found that the knowledge of radiation risks within the North of Scotland in the selected sample population was insufficient across all levels of the clinical team. Further, continuous education around the topic and future audit opportunities may help to optimise knowledge and training.
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Affiliation(s)
- Shannon Mellis
- Medical MBChB Graduate 2023, University of Aberdeen School of Medicine and Dentistry, Polwarth Building, Foresterhill Rd, Aberdeen, AB25 2ZD, UK.
| | - Yuxuan Zhang
- ST3 Clinical Radiology, Aberdeen Royal Infirmary, Foresterhill Health Campus, Foresterhill Rd, Aberdeen, AB25 2ZN, UK
| | - Dympna McAteer
- Consultant Radiologist, Aberdeen Royal Infirmary, Foresterhill Health Campus, Foresterhill Rd, Aberdeen, AB25 2ZN, UK
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Alashban Y, Alghamdi SA. Patient perspectives on ionising radiation exposure from computed tomography in Saudi Arabia: a knowledge and perception study. RADIATION PROTECTION DOSIMETRY 2024; 200:687-692. [PMID: 38678363 DOI: 10.1093/rpd/ncae106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/07/2024] [Accepted: 04/10/2024] [Indexed: 04/29/2024]
Abstract
The objective of this study was to evaluate patient knowledge and understanding of ionising radiation and dosage, as well as the accompanying risks related to computed tomography scans. A total of 412 outpatients who underwent computed tomography (CT) scans were surveyed to assess their understanding of radiation dose and exposure risks. CT was correctly classified as an ionising radiation by 56.8% of the respondents. More than half of the patients reported that a CT scan increases the probability of inducing cancer. Awareness of varying radiation doses in different CT exams was noted in 75.2% of patients, but only 21.4% reported having discussions with their physician about radiation dose. Gender, age and employment were significantly correlated with knowledge levels. The survey findings indicate a limited understanding of the hazards associated with ionising radiation used in CT scans, highlighting a need for increased awareness and education on radiation protection to ensure informed consent.
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Affiliation(s)
- Yazeed Alashban
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia
| | - Sami A Alghamdi
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 145111, Riyadh 4545, Saudi Arabia
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Alsubaie FH, Abujamea AH. Knowledge and Perception of Radiation Risk From Computed Tomography Scans Among Patients Attending an Emergency Department. Cureus 2024; 16:e52687. [PMID: 38384636 PMCID: PMC10879657 DOI: 10.7759/cureus.52687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 02/23/2024] Open
Abstract
To evaluate the level of knowledge about radiation dose and possible risks related to computed tomography (CT) scans among patients visiting emergency departments (EDs), a survey was conducted over a two-month period. A total of 357 adult patients (44% men and 56% women) presenting for diagnostic imaging in the ED answered a survey consisting of 15 questions. The survey included questions about the participants' demographics and knowledge of radiation. Most of the respondents (58.5%) reported that the physician did not explain the potential risk of radiation before the procedure. In addition, more than half of the respondents (58.1%) expressed feeling anxious about the potential risk of radiation. Most respondents (84.9%) stated that the potential radiation risk did not affect their decision to proceed with the procedure. Overall, the findings highlight a lack of information about radiation and its potential risks provided to patients prior to the diagnostic procedure. Increasing awareness and understanding of the risks associated with these imaging modalities should be considered essential in modern communities. Efforts should be made to ensure that patients undergoing diagnostic imaging are aware of the radiation risks they may encounter.
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Affiliation(s)
- Faisal H Alsubaie
- Department of Family and Community Medicine, King Saud University/College of Medicine, Riyadh, SAU
| | - Abdullah H Abujamea
- Department of Radiology and Medical Imaging, King Saud University/College of Medicine, Riyadh, SAU
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Matković A, Ferenc T, Dimjašević L, Drinković M, Lovreković B, Popić J, Mužar RM, Vidjak V. Patient's knowledge regarding radiation exposure from various imaging modalities: a pilot study. RADIATION PROTECTION DOSIMETRY 2023; 200:91-96. [PMID: 37930816 DOI: 10.1093/rpd/ncad276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 11/08/2023]
Abstract
To determine patients' knowledge about ionising radiation used in diagnostic imaging and whether they were adequately informed about the procedure they were referred to. A cross-sectional study was conducted at the University Hospital Merkur, Zagreb, Croatia during 2019-20. A questionnaire with 14 questions was given to patients in waiting rooms for imaging examinations. Statistical analysis was conducted using the standard software package. Chi-square with Yates correction was used to determine differences in patients' answers between those who received the explanation about the procedure and those who did not. The differences depending on the educational level were also evaluated. The survey was completed by 374 participants (200 women, 174 men) with a mean age of 55.45 ± 15.92 y. Of all patients, 8.63% had no formal education or only finished elementary school, 52.83% had finished high school and 38.55% had a college or a higher degree. The referring physicians informed 63.66% of participants about the radiological exam they were being referred to, and 226 thought that the given explanation was sufficient. Most patients knew that some radiological procedures use ionising radiation. Only 47.37% of respondents correctly identified MRI as a non-ionising method, whereas 37.40% of participants recognised chest X-ray as the modality with the lowest radiation dose. Higher-educated patients had better knowledge of radiological procedures and the potential risks. The study demonstrated suboptimal patients' knowledge about ionising radiation, and additional efforts in their education are needed.
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Affiliation(s)
- Andro Matković
- Department of Diagnostic and Interventional Radiology, University Hospital Merkur, 10000 Zagreb, Croatia
| | - Thomas Ferenc
- Department of Diagnostic and Interventional Radiology, University Hospital Merkur, 10000 Zagreb, Croatia
| | - Lucija Dimjašević
- Department of Diagnostic and Interventional Radiology, University Hospital Merkur, 10000 Zagreb, Croatia
| | - Martin Drinković
- Department of Radiology, Polyclinic Drinković, 10000 Zagreb, Croatia
| | - Bruno Lovreković
- Department of General and Sports Traumatology and Orthopedic Surgery, University Hospital Merkur, 10000 Zagreb, Croatia
| | - Jelena Popić
- Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, 10000 Zagreb, Croatia
- Department of Radiology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Rhea M Mužar
- Department for Plastic, Reconstructive and Aesthetic Surgery, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Vinko Vidjak
- Department of Diagnostic and Interventional Radiology, University Hospital Merkur, 10000 Zagreb, Croatia
- Department of Radiology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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Sullivan E, Danboise B, Hunt K, Hamblen M, Simmons M, Kumar S, Richman P. Do physicians counsel patients regarding radiation risks of CT?: A survey of emergency department patients. Am J Emerg Med 2023:S0735-6757(23)00350-9. [PMID: 37468432 DOI: 10.1016/j.ajem.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/01/2023] [Indexed: 07/21/2023] Open
Affiliation(s)
- Elizabeth Sullivan
- Department of Emergency Medicine, CHRISTUS Health/Texas A&M Health Science Center, Corpus Christi, TX, United States of America
| | - Brook Danboise
- Department of Emergency Medicine, CHRISTUS Health/Texas A&M Health Science Center, Corpus Christi, TX, United States of America
| | - Kaitlin Hunt
- Department of Emergency Medicine, CHRISTUS Health/Texas A&M Health Science Center, Corpus Christi, TX, United States of America
| | - Mary Hamblen
- Department of Emergency Medicine, CHRISTUS Health/Texas A&M Health Science Center, Corpus Christi, TX, United States of America
| | - Michael Simmons
- Department of Emergency Medicine, CHRISTUS Health/Texas A&M Health Science Center, Corpus Christi, TX, United States of America
| | - Shreya Kumar
- Department of Emergency Medicine, CHRISTUS Health/Texas A&M Health Science Center, Corpus Christi, TX, United States of America
| | - Peter Richman
- Department of Emergency Medicine, CHRISTUS Health/Texas A&M Health Science Center, Corpus Christi, TX, United States of America.
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Moon J. The relationship between radiofrequency-electromagnetic radiation from cell phones and brain tumor: The brain tumor incidence trends in South Korea. ENVIRONMENTAL RESEARCH 2023; 226:115657. [PMID: 36906274 DOI: 10.1016/j.envres.2023.115657] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 05/20/2023]
Abstract
INTRODUCTION The aim of this study is to investigate the relationship between the nationwide cell phone subscription rate and the nationwide incidence of brain tumors in South Korea. The nationwide cell phone subscription rate was used as a proxy for the RF-EMR exposure assessment. METHODS The data for cell phone subscriptions per 100 persons from 1985 to 2019 were found in the Statistics, International Telecom Union (ITU). The brain tumor incidence data from 1999 to 2018 provided by the South Korea Central Cancer Registry operated by the National Cancer Center were used. RESULTS In South Korea, the subscription rate increased from 0 per 100 persons in 1991 to 57 per 100 persons in 2000. The subscription rate became 97 per 100 persons in 2009 and 135 per 100 persons in 2019. For the correlation coefficient between cell phone subscription rate before 10 years and ASIR per 100,000, a positive correlation coefficient with a statistical significance was reported in 3 benign brain tumors (International Classification of Diseases, ICD-10 code, D32, D33, and D32.0) and in 3 malignant brain tumors (ICD-10 code, C71.0, C71.1, and C71.2). Positive correlation coefficients with a statistical significance in malignant brain tumors ranged from 0.75 (95% CI 0.46-0.90) for C71.0 to 0.85 (95% CI 0.63-0.93) for C71.1. DISCUSSION In consideration of the fact that the main route for RF-EMR exposure has been through the frontotemporal side of the brain (the location of both ears), the positive correlation coefficient with a statistical significance in the frontal lobe (C71.1) and temporal lobe (C71.2) can be understood. Statistically insignificant results from recent cohort and large population international studies and contrasting results from many previous case-control studies could indicate a difficulty in identifying a factor as a determinant of a disease in ecological study design.
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Affiliation(s)
- Jinyoung Moon
- Department of Occupational and Environmental Medicine, Inha University Hospital, Inhang-ro 27, Jung-gu, Incheon, 22332, South Korea; Department of Environmental Health Science, Graduate School of Public Health, Seoul National University, Gwanak-ro 1, Gwanak-gu, Seoul, 08826, South Korea.
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Nagendra V, Dhande R, Mishra G, Reddy NG, Gowda H. Hematuria as a Sign of Kidney Stone Disease Evaluated Using Computed Tomography: A Review. Cureus 2023; 15:e38064. [PMID: 37252589 PMCID: PMC10212727 DOI: 10.7759/cureus.38064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 04/24/2023] [Indexed: 05/31/2023] Open
Abstract
Kidney stone is a common cause of acute pain in the abdomen in patients presenting to casualty. Being present in roughly 12% of the world's population makes it the most prevalent pathology of the urinary system. The ureters, kidneys, and bladder frequently develop calculi, resulting in hematuria. The most effective imaging technique for evaluating calculi is unenhanced helical computed tomography. The population, intervention, control, and outcomes (PICO)-formatted question was used to generate methodological medical subject heading (MeSH) phrases, which increased the search strategy's sensitivity in finding research. Some of these names ("hematuria") included "renal calculi" (MeSH) and "cone-beam computed tomography" (MeSH). Studies that satisfied these requirements were subjected to critical evaluation. The merits of the listed studies were evaluated using a unique quality assessment scale. The most accurate imaging diagnostic test for people with hematuria is multidetector computed tomography. If a patient over 40 presents with microscopic hematuria, a non-contrast computed tomography or ultrasound study should be performed, and if gross hematuria is observed, cystoscopy should be added. Pre- and post-contrast computed tomography scans and cystoscopy should be carried out on elderly patients.
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Affiliation(s)
- Vadlamudi Nagendra
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rajasbala Dhande
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Gaurav Mishra
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nidhi G Reddy
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Harshith Gowda
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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The why, who, how, and what of communicating CT radiation risks to patients and healthcare providers. ABDOMINAL RADIOLOGY (NEW YORK) 2023; 48:1514-1525. [PMID: 36799998 DOI: 10.1007/s00261-022-03778-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 02/18/2023]
Abstract
Computed tomography (CT) has witnessed tremendous growth in utilization. Despite its immense benefits, there is a growing concern from the general public and the medical community about the detrimental consequences of ionizing radiation from CT. Anxiety from the perceived risks associated with CT can deter referring physicians from ordering clinically indicated CT scans and patients from undergoing medically necessary exams. This article discusses various strategies for educating patients and healthcare providers on the benefits and risks of CT scanning and salient techniques for effective communication.
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Implementation of a Magnetic Resonance Imaging scanner dedicated to emergencies in cases of binocular diplopia: Impact on patient management. J Neuroradiol 2023; 50:22-29. [PMID: 33864897 DOI: 10.1016/j.neurad.2021.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/23/2021] [Accepted: 03/26/2021] [Indexed: 01/31/2023]
Abstract
RATIONALE AND OBJECTIVES Evaluate the implementation of an MRI scanner dedicated to emergencies on the management of patients admitted in the emergency department (ED) for binocular diplopia (BD). MATERIAL AND METHODS This was a prospective non-interventional single-center study from February 2018 to February 2020. A total of 110 patients were included: 52 patients during the first stage (29 women; 23 men; mean age 65.2 years); 58 during the second stage (29 women; 29 men; mean age 51.4 years). Patients underwent an enhanced-CT examination in the first stage and an MRI examination in the second stage. Criteria used to evaluate the new management of patients were: proportion of patients with an imaging diagnosis explaining BD, turnaround time (TT), ED length of stay (EDLOS), hospital admission rate, hospital length of stay (HLOS), number of MRI examinations requested as a second procedure for the same indication and radiation doses. Descriptive statistics were used to present results with Student's test for quantitative variables and chi-square test for qualitative variables. RESULTS Respectively 1 (1.92%) and 17 (29.31%) patients had definitive diagnosis in stages 1 and 2, with a significant difference in examination modalities (p=0.0001). The TT, EDLOS, hospital admission rate, and HLOS were not significantly different between the two stages. Radiation dose was significantly different between the two groups (p<0.05). CONCLUSION Implementation of an MRI scanner dedicated to emergencies can improve the etiological diagnostic performance of binocular diplopia and reduce patient's exposure to ionizing radiation without increasing the average turnaround time or emergency department length of stay.
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Amaoui B, Safini F, Lahlou L, El Fahssi M, Abbaoui S, Semghouli S. Physicians’ knowledge about radiation protection of patients during prescription of CT scan procedures in Morocco. RADIATION MEDICINE AND PROTECTION 2023. [DOI: 10.1016/j.radmp.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
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Hijji FY, Schneider AD, Thomas MD, Lyons JG, Bohl DD, Jerele JL, Prayson MJ. Knowledge of radiation exposure associated with common trauma imaging modalities among orthopaedic surgeons, emergency medicine physicians, and general surgeons in the United States. World J Emerg Med 2023; 14:294-301. [PMID: 37425084 PMCID: PMC10323512 DOI: 10.5847/wjem.j.1920-8642.2023.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/02/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Few contemporary studies have assessed physicians' knowledge of radiation exposure associated with common imaging studies, especially in trauma care. The purpose of this study was to assess the knowledge of physicians involved in caring for trauma patients regarding the effective radiation doses of musculoskeletal (MSK) imaging studies routinely utilized in the trauma setting. METHODS An electronic survey was distributed to United States orthopaedic surgery, general surgery, and emergency medicine (EM) residency programs. Participants were asked to estimate the radiation dose for common imaging modalities of the pelvis, lumbar spine, and lower extremity, in terms of chest X-ray (CXR) equivalents. Physician estimates were compared to the true effective radiation doses. Additionally, participants were asked to report the frequency of discussing radiation risk with patients. RESULTS A total of 218 physicians completed the survey; 102 (46.8%) were EM physicians, 88 (40.4%) were orthopaedic surgeons, and 28 (12.8%) were general surgeons. Physicians underestimated the effective radiation doses of nearly all imaging modalities, most notably for pelvic computed tomaography (CT) (median 50 CXR estimation vs. 162 CXR actual) and lumbar CT (median 50 CXR estimation vs. 638 CXR actual). There was no difference between physician specialties regarding estimation accuracy (P=0.133). Physicians who regularly discussed radiation risks with patients more accurately estimated radiation exposure (P=0.007). CONCLUSION The knowledge among orthopaedic and general surgeons and EM physicians regarding the radiation exposure associated with common MSK trauma imaging is lacking. Further investigation with larger scale studies is warranted, and additional education in this area may improve care.
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Affiliation(s)
- Fady Y. Hijji
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton OH 45409, USA
| | - Andrew D. Schneider
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton OH 45409, USA
| | - Matthew D. Thomas
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton OH 45409, USA
| | - Joseph G. Lyons
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton OH 45409, USA
| | - Daniel D. Bohl
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago IL 60612, USA
| | - Jennifer L. Jerele
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton OH 45409, USA
| | - Michael J. Prayson
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton OH 45409, USA
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Evaluating the Outcome of an Unnecessary Request for CT Scan in Be'sat Hospital of Hamadan. Radiol Res Pract 2023; 2023:3709015. [PMID: 36874208 PMCID: PMC9977522 DOI: 10.1155/2023/3709015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 02/24/2023] Open
Abstract
Aim This study aimed to investigate the frequency of unnecessary tests requested in Be'sat Hospital in Hamadan. Materials and Methods This descriptive research was conducted in order to investigate the frequency of unnecessary requests for CT scan and radiography of patients referring to the imaging department of Be'sat Hospital in Hamadan in a 4- to 6-month period. Patient information, including gender, age, type of CT scan test, the reason for requesting the test, the expertise of the requesting physician, and the result of the radiologist's report on each test, was extracted and collected. Results A total of 1000 CT scans were evaluated. The mean age of these patients was about 36 years and most of them were men. The highest and lowest percentages of unnecessary cases were related to CT scans of the brain (42.3%) and facial bones (2.3%), respectively. The most and the least unnecessary CT scans based on the reason given for the request were related to multiple physical trauma (30.7%) and chronic kidney disease (1.5%), respectively. Conclusion In all tests, over 74% of the reports were unnecessary and less than 26% were necessary. Therefore, it is necessary to reduce unnecessary requests to reduce the radiation dose of patients. Also, the knowledge of doctors should be increased in the field of appropriate evaluation of CT scan tests based on clinical guidelines.
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Acharya R, Kafle S, Shrestha DB, Sedhai YR, Ghimire M, Khanal K, Malla QB, Nepal U, Shrestha R, Giri B. Use of Computed Tomography of the Head in Patients With Acute Atraumatic Altered Mental Status: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2242805. [PMID: 36399344 PMCID: PMC9675006 DOI: 10.1001/jamanetworkopen.2022.42805] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 10/06/2022] [Indexed: 11/19/2022] Open
Abstract
Importance The usefulness of computed tomography of the head (CTH) in patients with acute-onset atraumatic altered mental status (AMS) is poorly understood, but use in these patients remains high. Objective To evaluate the use of CTH (event rate) in patients with AMS and the positive outcome event rate of the performed CTH studies. Data Sources The PubMed/MEDLINE, PubMed Central, Embase, and CINAHL databases were searched using predefined Boolean parameters. All studies that met inclusion criteria until January 31, 2022, were included. Study Selection Randomized clinical trials and observational, cohort, and case-control studies were included. Conference abstracts, reviews, letters, case reports, case series, systematic literature, and meta-analyses were excluded. Data Extraction and Synthesis The systematic literature review was performed per Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Data were independently extracted by 2 authors. Data were pooled using a random-effects method. Main Outcomes and Measures Event rate of CTH use in patients with acute atraumatic AMS. The CTH event rates and positive CTH event rates were calculated with 95% CIs. Results Of 9338 studies identified, 26 qualified for the systematic review and 25 for the meta-analysis. The 25 studies in the meta-analysis included a total of 79 201 patients. The CTH event rate was 94% (proportion, 0.94; 95% CI, 0.76-1.00), and the positive CTH event rate was 11% (proportion, 0.11; 95% CI, 0.07-0.15). There was significant heterogeneity among the studies included (I2 > 50%, P < .001), for which a random-effects model was used. There was significant publication bias, as evident by an asymmetric funnel plot. There was no fluctuation of the results during the sensitivity analysis, which reassured the reliability of the data. Conclusions and Relevance In this meta-analysis, CTH use among patients with acute-onset atraumatic AMS was very high with a low yield. Large-scale studies are needed to guide clinical decision-making in such a situation.
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Affiliation(s)
- Roshan Acharya
- Division of Pulmonary and Critical Care Medicine, Virginia Tech Carilion School of Medicine, Carilion Roanoke Memorial Hospital, Roanoke
| | - Smita Kafle
- Department of Nursing, Fayetteville State University School of Nursing, Fayetteville, North Carolina
| | | | - Yub Raj Sedhai
- Division of Pulmonary and Critical Care Medicine, University of Kentucky, Bowling Green
| | - Meera Ghimire
- Department of Internal Medicine, Cape Fear Valley Medical Center, Fayetteville, North Carolina
| | - Kishor Khanal
- Department of Critical Care Medicine, Nepal Mediciti Hospital, Kathmandu, Nepal
| | - Queen Baba Malla
- Department of Internal Medicine, Nepalgunj Medical College, Kohalpur, Nepal
| | - Uttam Nepal
- Department of Internal Medicine, Kist Medical College, Lalitpur, Nepal
| | - Rojina Shrestha
- Department of Internal Medicine, Kist Medical College, Lalitpur, Nepal
| | - Badri Giri
- Division of Pulmonary and Critical Care Medicine, Virginia Tech Carilion School of Medicine, Carilion Roanoke Memorial Hospital, Roanoke
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Oglat AA, Hasan H. Jordanian women’s (studying or working in medical fields) awareness in terms of the use of dental imaging during pregnancy. BMC Oral Health 2022; 22:427. [PMID: 36153531 PMCID: PMC9508717 DOI: 10.1186/s12903-022-02459-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 09/13/2022] [Indexed: 11/20/2022] Open
Abstract
Background The anxiety among pregnant women about the imaging of teeth during pregnancy may have an adverse effect on the oral health of both the mother and the fetus too. This research study was conducted to evaluate women’s knowledge of the utilization of dental imaging during pregnancy. Methods In this research, structured questionnaires were distributed electronically through social media. The questionnaires contained questions focused on the women’s (studying or working in medical fields) awareness regarding the ionizing radiation protection that takes place during dental imaging, the safest period for dental imaging, the sort of radiographs that can be required, and the chance of radiation-induced malignant tumor and malformation of the fetal as a result of dental imaging. Results Overall, 984 participants completed questionnaires that were analyzed after being received. Most of the participants (n = 637; 64.7%) were < 30 years of age. The greater number of the participants (66.8%) had fair knowledge of dental imaging. 25.4% mentioned that pregnant women are able to do dental imaging during the first trimester. And approximately half of the participants thought that cone-beam computed tomography and panoramic images must not be carried out during pregnancy. Moreover, nearly the same percentage of them also believed that the risk of inborn malformation is high due to dental imaging. Conclusions The results refer to a low awareness among people who have medical knowledge regarding dental radiograph protection during pregnancy. This needs to be paid attention to among students, graduates, and workers in medical fields by focusing on the courses and lectures related to dental imaging protection during pregnancy. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02459-w.
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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: 1] [Impact Index Per Article: 0.3] [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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Ahmed SS, Onyambu CK, Omamo E, Odhiambo A. Appropriateness of imaging modality choice by doctors at the Kenyatta National Hospital's Accident and Emergency Department. SA J Radiol 2022; 26:2367. [PMID: 35812704 PMCID: PMC9257894 DOI: 10.4102/sajr.v26i1.2367] [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] [Received: 12/06/2021] [Accepted: 04/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background Clinical imaging guidelines assist doctors in selecting the most appropriate radiological investigation(s) according to the patient's clinical presentation and also help to avoid unnecessary radiation exposure. Objectives This study aimed to determine the appropriateness of choice of imaging procedures requested by the doctors in the Accident and Emergency Department (A&E) of Kenyatta National Hospital (KNH). Method Request forms sent to the KNH Radiology Department from the A&E Department from 01 July 2019 to 31 October 2019 were captured digitally. The request forms were de-identified to ensure confidentiality of patients and requesting doctors. Only the demographic data, clinical summary and radiological examination requested were extracted. Results A total of 1053 imaging request forms were captured and analysed using the American College of Radiology (ACR) appropriateness criteria. Adequate clinical summary was provided in 81.3% of the request forms. Appropriate imaging requests were 51.9% whilst inappropriate imaging requests were 34.6%. The clinical scenarios of 13.6% of the imaging requests were not found in the ACR database. Imaging modalities using ionising radiation formed the bulk of the inappropriate investigations at 72.8%. Of these, CT scan had the highest individual inappropriate requests of 49.3%. Only 18.4% of female patients in the reproductive age group had a documented last menstrual period. Conclusion Imaging modalities using ionising radiation had the highest percentage of inappropriate radiological requests, especially CT scans requested in the trauma setting. In addition, some clinical scenarios were not captured in the ACR appropriateness criteria, hence the need for local imaging guidelines.
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Affiliation(s)
- Salman S Ahmed
- Department of Diagnostic Imaging & Radiation Medicine, Faculty of Radiology, University of Nairobi, Nairobi, Kenya
| | - Callen K Onyambu
- Department of Diagnostic Imaging & Radiation Medicine, Faculty of Radiology, University of Nairobi, Nairobi, Kenya
| | - Eunice Omamo
- Department of Radiology, Kenyatta National Hospital, Nairobi, Kenya
| | - Alfred Odhiambo
- Department of Radiology, University of Nairobi, Nairobi, Kenya
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Kim E, Boyd B. Diagnostic Imaging of Pregnant Women and Fetuses: Literature Review. Bioengineering (Basel) 2022; 9:236. [PMID: 35735479 PMCID: PMC9220222 DOI: 10.3390/bioengineering9060236] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 01/21/2023] Open
Abstract
Healthcare providers have acknowledged the dangers of radiation exposure to embryonic and fetal health, yet diagnostic imaging of pregnant women is increasing. Literature that pertains to the topic of interest was reviewed to collect tertiary data. The purpose of this literature review was to present the various radiation risks for pregnant women and the fetus depending on the gestational age of the pregnancy. The specific effects of radiation on pregnant women and the fetus, X-ray risks depending on the gestational age of the pregnancy, and other potential health effects when performing diagnostic imaging procedures on pregnant women were discussed in this review. In addition, ethical issues have been considered by improving overall communication to minimize unnecessary radiation exposure to pregnant women and fetuses.
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Affiliation(s)
- Eunhye Kim
- Department of Health Safety Convergence Science, Korea University, Seoul 02481, Korea;
| | - Brenda Boyd
- Department of Radiation Science, Loma Linda University, Loma Linda, CA 92350, USA
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21
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Gengler I, Hsieh TY. Secondary Correction of Posttraumatic Enophthalmos. Facial Plast Surg 2022; 38:364-374. [PMID: 35545118 DOI: 10.1055/a-1849-5491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Posttraumatic enophthalmos (PE) arises when the ocular globe is displaced posteriorly and inferiorly in the orbital cavity due to a mismatch in orbital volume and orbital content. This most commonly happens after orbital fractures. The resulting disruptions to aesthetic form and ocular functions often necessitate surgical correction for reconstruction and restoration. The purpose of surgical management of PE is to reconstruct orbital shape and volume as well as to restore any herniated orbital content. This can be particularly challenging in cases involving large defects that require complex orbital reconstruction. Recent advancements in computer-aided surgery have introduced innovative and important tools to assist surgeons with these difficult cases. The ability to create customized, patient-specific implants can facilitate reconstruction involving complicated anatomy. Additionally, intraoperative imaging and intraoperative navigation can serve as useful guides for surgeons to more accurately place implants, especially in cases with limited visualization, in order to achieve optimal outcomes.
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Affiliation(s)
- Isabelle Gengler
- Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, United States
| | - Tsung-Yen Hsieh
- Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, United States
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22
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Vassileva J, Zewde NT, Reim M, Holmberg O, Rehani MM. Communication of radiation risk from imaging studies: an IAEA-coordinated international survey. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2022; 42:021524. [PMID: 35320786 DOI: 10.1088/1361-6498/ac6047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/23/2022] [Indexed: 06/14/2023]
Abstract
The purpose of this IAEA-coordinated international study was to understand aspects related to the communication of radiation risk from imaging studies, such as how often imaging department personnel and referring physicians are asked about radiation risks in diagnostic imaging, who asks about these risks, how often professionals are able to provide satisfactory answers using qualitative metrics and how often quantitative risk estimates are needed. A web-based questionnaire with ten questions was completed by 386 healthcare professionals from 63 countries from all four continents, including clinicians/referring physicians (42.5%), radiologists or nuclear medicine physicians (26.7%), medical physicists (23.1%), radiographers/radiological technologists (6.2%) and others (1.6%). The results indicate that radiation risk-related questions are largely asked by patients (73.1%) and parents of child patients (38.6%), and 78% of the professionals believe they are able to answer those questions using qualitative metrics such as very small/minimal, small, medium rather than number of cancers likely occurring. The vast majority, with over three times higher frequency, indicated the purpose of knowing previous radiological exams as 'both clinical information and radiation exposure history' rather than 'only clinical information'. Nearly two-thirds of the clinicians/referring physicians indicated that knowing the radiation exposure history of the patient will affect their decision-making for the next exam, as against only about one-fifth who said 'no, it will not affect their decision-making'. The same question, when addressed to radiologists, resulted in a slightly larger fraction of about three-quarters who said 'yes', as opposed to a smaller fraction of about 12% who said 'no, it will not affect their decision-making'. Mapping the present situation of communication of benefits and risks for patients is important and may be the basis of further analysis, regular monitoring and possibly a target for clinical audits. Further studies focused on specific professional groups might help in obtaining á deeper understanding of the need for practical communication tools.
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Affiliation(s)
- Jenia Vassileva
- Radiation Protection of Patients Unit, International Atomic Energy Agency, Vienna, Austria
| | | | | | - Ola Holmberg
- Radiation Protection of Patients Unit, International Atomic Energy Agency, Vienna, Austria
| | - Madan M Rehani
- Massachusetts General Hospital, Boston, MA, United States of America
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Tzanis E, Damilakis J. A novel methodology to train and deploy a machine learning model for personalized dose assessment in head CT. Eur Radiol 2022; 32:6418-6426. [PMID: 35384458 DOI: 10.1007/s00330-022-08756-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/28/2022] [Accepted: 03/19/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To propose a machine learning-based methodology for the creation of radiation dose maps and the prediction of patient-specific organ/tissue doses associated with head CT examinations. METHODS CT data were collected retrospectively for 343 patients who underwent standard head CT examinations. Patient-specific Monte Carlo (MC) simulations were performed to determine the radiation dose distribution to patients' organs/tissues. The collected CT images and the MC-produced dose maps were processed and used for the training of the deep neural network (DNN) model. For the training and validation processes, data from 231 and 112 head CT examinations, respectively, were used. Furthermore, a software tool was developed to produce dose maps from head CT images using the trained DNN model and to automatically calculate the dose to the brain and cranial bones. RESULTS The mean (range) percentage differences between the doses predicted from the DNN model and those provided by MC simulations for the brain, eye lenses, and cranial bones were 4.5% (0-17.7%), 5.7% (0.2-19.0%), and 5.2% (0.1-18.9%), respectively. The graphical user interface of the software offers a user-friendly way for radiation dose/risk assessment. The implementation of the DNN allowed for a 97% reduction in the computational time needed for the dose estimations. CONCLUSIONS A novel methodology that allows users to develop a DNN model for patient-specific CT dose prediction was developed and implemented. The approach demonstrated herein allows accurate and fast radiation dose estimation for the brain, eye lenses, and cranial bones of patients who undergo head CT examinations and can be used in everyday clinical practice. KEY POINTS • The methodology presented herein allows fast and accurate radiation dose estimation for the brain, eye lenses, and cranial bones of patients who undergo head CT examinations and can be implemented in everyday clinical practice. • The scripts developed in the current study will allow users to train models for the acquisition protocols of their CT scanners, generate dose maps, estimate the doses to the brain and cranial bones, and estimate the lifetime attributable risk of radiation-induced brain cancer.
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Affiliation(s)
- Eleftherios Tzanis
- Department of Medical Physics, School of Medicine, University of Crete, P.O. Box 2208, 71003, Heraklion, Crete, Greece
| | - John Damilakis
- Department of Medical Physics, School of Medicine, University of Crete, P.O. Box 2208, 71003, Heraklion, Crete, Greece.
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AKAY G, ÖZDEDE M, KARADAĞ Ö. Informed Consent in Dentomaxillofacial Radiology: A Cross- Sectional Study. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022. [DOI: 10.33808/clinexphealthsci.1012561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: This study assessed the opinions and attitudes of dentomaxillofacial (DMF) radiology physicians worldwide about informed consent in terms of oral radiology applications.
Methods: DMF radiology physicians in various countries were invited to this study via e-mail. The participants answered their demographic information (gender, age, years of experience, title, institution, and country), and questions about informed consent. The Pearson chi-square and Fisher’s exact tests were used for statistical analysis
Results: From 22 countries, 46 male (51.7%) and 43 female (48.3%) DMR radiology physicians completed the questionnaire. More than half of the participants (53.9%) were working in the university hospital, and the highest number of participants (32.6%) was from the European region. Most of the surveyors (70.8%) stated that consent is required in dental radiology. No statistically significant difference was found in the radiographic methods (intraoral, panoramic/extraoral, and cone-beam CT) applied in terms of obtaining consent (p > 0.05). While middle-aged physicians (30 –45 age) thought that patients should not be informed about the risk of radiation causing cancer, experienced participants (45 age and above) stated that information should be given about the cancer risk (p < 0.05).
Conclusion: The results of this study showed that most of the DMF radiology physicians stated that they have responsibility for getting informed consent and only one-third of the participants inform patients about the risks of radiation.
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Affiliation(s)
- Gülsün AKAY
- GAZI UNIVERSITY, FACULTY OF DENTISTRY, DEPARTMENT OF CLINICAL SCIENCES, DEPARTMENT OF ORAL,DENTAL AND MAXILLOFACIAL RADIOLOGY
| | - Melih ÖZDEDE
- PAMUKKALE ÜNİVERSİTESİ, DİŞ HEKİMLİĞİ FAKÜLTESİ, KLİNİK BİLİMLER BÖLÜMÜ, AĞIZ DİŞ VE ÇENE RADYOLOJİSİ ANABİLİM DALI
| | - Özge KARADAĞ
- HACETTEPE UNIVERSITY, FACULTY OF SCIENCE, DEPARTMENT OF STATISTICS
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A Survey of Awareness of Parents and Caretakers on Diagnostic Radiological Examination Related Radiation Exposure in a Tertiary Hospital in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073898. [PMID: 35409582 PMCID: PMC8998027 DOI: 10.3390/ijerph19073898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND With the advancement in medical imaging, radiological application in the paediatric population has also increased. Children, generally more radiosensitive, have a higher risk of developing certain malignancies. Therefore, this may result in uneasiness among parents and caretakers when their children need to undergo medical imaging examination. Hence, this study aims to assess the awareness of parents' and caretakers' awareness of medical imaging-related radiation exposure in our institution and their opinion of a medical radiation exposure-tracking programme for the paediatric population. METHODOLOGY A cross-sectional survey was conducted for 6 months duration among parents and caretakers, who brought their children (under 12 years old) for imaging. The questionnaire booklet had eleven knowledge-based questions to assess respondents on ionising radiation-associated medical imaging, the radiation-related risk and radiation safety precaution. RESULTS Two hundred and fifteen respondents participated in this survey. More than 40% of the respondents failed to identify various dose-saving and ionising radiation-related imaging methods. Only 87 participants (40.5%) could correctly answer at least six out of eleven knowledge-based questions. Moreover, 88.4% of the respondents support a medical radiation exposure-tracking programme for their children. CONCLUSION Parents and caretakers who visited our institution had inadequate awareness of medical radiation exposure. Appropriate measures need to be taken to address this promptly. Implementation of a medical radiation exposure-tracking programme for the paediatric population is considered timely as most respondents agree with this programme.
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Seol YJ, Kim YJ, Kim YS, Cheon YW, Kim KG. A Study on 3D Deep Learning-Based Automatic Diagnosis of Nasal Fractures. SENSORS 2022; 22:s22020506. [PMID: 35062465 PMCID: PMC8780993 DOI: 10.3390/s22020506] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 12/11/2022]
Abstract
This paper reported a study on the 3-dimensional deep-learning-based automatic diagnosis of nasal fractures. (1) Background: The nasal bone is the most protuberant feature of the face; therefore, it is highly vulnerable to facial trauma and its fractures are known as the most common facial fractures worldwide. In addition, its adhesion causes rapid deformation, so a clear diagnosis is needed early after fracture onset. (2) Methods: The collected computed tomography images were reconstructed to isotropic voxel data including the whole region of the nasal bone, which are represented in a fixed cubic volume. The configured 3-dimensional input data were then automatically classified by the deep learning of residual neural networks (3D-ResNet34 and ResNet50) with the spatial context information using a single network, whose performance was evaluated by 5-fold cross-validation. (3) Results: The classification of nasal fractures with simple 3D-ResNet34 and ResNet50 networks achieved areas under the receiver operating characteristic curve of 94.5% and 93.4% for binary classification, respectively, both indicating unprecedented high performance in the task. (4) Conclusions: In this paper, it is presented the possibility of automatic nasal bone fracture diagnosis using a 3-dimensional Resnet-based single classification network and it will improve the diagnostic environment with future research.
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Affiliation(s)
- Yu Jin Seol
- Department of Biomedical Engineering, Gachon University, 191, Hambangmoe-ro, Yeonsu-gu, Incheon 21936, Korea;
| | - Young Jae Kim
- Department of Biomedical Engineering, Gachon University College of Medicine, 38-13 Docjeom-ro 3 beon-gil, Namdong-gu, Incheon 21565, Korea;
| | - Yoon Sang Kim
- Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, College of Medicine, Incheon 21565, Korea;
| | - Young Woo Cheon
- Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, College of Medicine, Incheon 21565, Korea;
- Correspondence: (Y.W.C.); (K.G.K.)
| | - Kwang Gi Kim
- Department of Biomedical Engineering, Gachon University College of Medicine, 38-13 Docjeom-ro 3 beon-gil, Namdong-gu, Incheon 21565, Korea;
- Department of Health Sciences and Technology, Gachon Advanced Institute for Health Sciences and Technology (GAIHST), Gachon University, Seongnam-si 13120, Korea
- Correspondence: (Y.W.C.); (K.G.K.)
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Factors Influencing Protective Behaviors for Dental Radiation Exposure among Female Korean Dental Hygienists Using Health Belief Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010518. [PMID: 35010778 PMCID: PMC8744896 DOI: 10.3390/ijerph19010518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/01/2022] [Accepted: 01/02/2022] [Indexed: 11/28/2022]
Abstract
This study aimed to identify the associated factors for protective behaviors for dental radiation exposure (PBDRE) among dental hygienists using the health belief model (HBM). The HBM, which is composed of perceived susceptibility, perceived seriousness, perceived benefits, perceived barriers, and cues to action, explains preventive behavior. In this study, self-efficacy and modifying factors were additionally applied to the HBM. The subjects of the study were 204 dental hygienists who were working at hospitals or clinics in Korea. An online survey was conducted to measure PBDRE-related factors based on the HBM and self-efficacy. The collected data were analyzed using frequency analysis, t-tests, ANOVA, Pearson’s correlation analysis, and hierarchical multiple regression analysis. Regarding modifying factors, performance was found to be high when protection facilities were sufficient (β = 0.24, p < 0.001) and low when radiation education was not received (β = −0.16, p < 0.05). Among the HBM factors, cues to action for PBDRE (β = 0.28, p < 0.001) was the most influential factor in the performance of PBDRE, and the effect of its perceived benefits on radiation exposure was also high (β = 0.17, p < 0.001). Regarding the performance of PBDRE according to the HBM, providing education programs on protection can stimulate appropriate cues to action to perform PBDRE. In addition, if the benefits of PBDRE are highlighted, the performance of PBDRE by dental hygienists is increased.
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Ghaleb A, Roa L, Marchenko N. Low-dose but not high-dose γ-irradiation elicits the dominant-negative effect of mutant p53 in vivo. Cancer Lett 2022; 530:128-141. [DOI: 10.1016/j.canlet.2022.01.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/05/2022] [Accepted: 01/15/2022] [Indexed: 12/17/2022]
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Groene OR, Bergelt C, Ehrhardt M. How good are medical students at communicating risk? An implementation study at three German medical schools. PATIENT EDUCATION AND COUNSELING 2022; 105:128-135. [PMID: 34020838 DOI: 10.1016/j.pec.2021.05.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/01/2021] [Accepted: 05/11/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To assess the objective and subjective risk communication skills of medical students in three universities in Germany METHODS: We developed a risk communication skills Objective Structured Clinical Examination (OSCE) station and implemented it in three medical schools in Germany. 596 students contributed data to a risk communication checklist and a risk communication self-assessment. Multiple linear regression models were used to identify factors associated with the risk communication OSCE performance. RESULTS Participants in our study achieved on average 73.5% of the total risk communication skills score, which did not differ between locations (F(2-595) = 1.96; p = 0.142). The mean objective performance of students who assessed their skills as poor was significantly worse than the performance of students who assessed their skills as good (t(520) = -5.01, p < 0.001). The risk communication skills score was associated with native language but not with gender nor General Point Average (p < 0.001). CONCLUSIONS Medical students demonstrated acceptable risk communication skills scores and were able to self-assess their performance. However, selected communication techniques should be re-emphasised in the undergraduate medical curriculum. PRACTICE IMPLICATIONS Our research identified shortcomings in particular subgroups that can be addressed through tailored curriculum interventions.
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Affiliation(s)
- Oana R Groene
- Institute of Biochemistry and Molecular Cell Biology, Center for Experimental Medicine, University Medical Center Hamburg-Eppendorf, Germany.
| | - Corinna Bergelt
- Corinna Bergelt, Institute of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany
| | - Maren Ehrhardt
- Maren Ehrhardt, Institute of General Practice, University Medical Center Hamburg-Eppendorf, Germany
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Thacker PJ, Sethi M, Sternlieb J, Schneider D, Naglak M, Patel RR. Rapid Response: To Scan or Not to Scan? The Utility of Noncontrast CT Head for Altered Mental Status. J Patient Saf 2021; 17:e1125-e1129. [PMID: 29346176 DOI: 10.1097/pts.0000000000000447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aims of the study were the following: (1) to determine how often computed tomography (CT) scans of the head are obtained on rapid responses called for altered mental status (AMS), (2) to determine whether CT imaging of the head is required during all rapid responses called for AMS, (3) to determine which patients would benefit from CT scans of the head in this setting, (4) to note whether an adequate neurologic exam was documented, (5) to determine the cost of CT scans that did not change management, and (6) to examine the role of medications leading to AMS. METHODS The study was a retrospective chart review at Abington Jefferson Hospital. Data collected included the age, sex, time of rapid response, clinical condition of the patient, whether an arterial blood gas and blood glucose were done, and whether a neurological exam was documented in the resident's rapid response team note. The patien's medications were also reviewed. Computed tomography scan findings as well as changes made in a patient's care as a result of the scan were recorded. Any findings that did not lead to a change in management were considered a "negative" scan. RESULTS Overall, 610 rapid responses were activated from January to August 2016. One hundred four (17.04%) of the total rapid responses were for AMS and 83 (79.8%) of these patients underwent noncontrast CT scan of the head. The mean (SD) age of the patients was 74.7 (13.6) years. A total of 56.6% were female. The most frequent clinical conditions documented at the time of rapid responses were noted as confused (33.7%, 28/83), either lethargic or unconscious (32.5%, 27/83), and concern for stroke (21.7%, 18/83). A total of 96.4% (80/83) of the CT scans done were negative for any acute changes. The three patients with positive scans (3/83) had a change in management as a result of the scans. If patients with symptoms concerning for stroke and unconscious patients are excluded, the total number of remaining patients is 56. Of these, zero patients had a positive scan. A total of 64.7% of the rapid response teams were activated either in the afternoon (31.3%) or at night (33.7%). A total of 33.7% had a complete neurological exam documented. A total of 66.2% were either incomplete (34.9%) or absent (31.3%). Sixty percent of the patients who had a CT head for AMS also had a blood sugar checked at bedside. Thirty-eight percent had an arterial blood gas. More than half the patients were taking one or more sedating medications (45/83, 57.8%). Most patients were not on anticoagulants (79.5%). CONCLUSIONS The findings of this study suggest that CT scan of the head is useful in older patients, patients with symptoms concerning for stroke, or cases of sudden onset of impaired consciousness. Noncontrast CT scans of the head are not useful for other presentations of AMS.
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Affiliation(s)
- Purujit J Thacker
- From the Abington Hospital, Jefferson Health, Abington, Pennsylvania
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Women's awareness regarding the use of dental imaging during pregnancy. BMC Oral Health 2021; 21:357. [PMID: 34284764 PMCID: PMC8290609 DOI: 10.1186/s12903-021-01726-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/15/2021] [Indexed: 11/14/2022] Open
Abstract
Background There is often anxiety among pregnant women about dental imaging during pregnancy. This may hinder some women from seeking dental treatment during pregnancy and consequently, may negatively affect the oral health of the mother and fetus. This study was conducted to assess women’s awareness regarding the use of dental imaging during pregnancy. Methods In this cross-sectional study, the electronic distribution of structured questionnaires was done via social media. The self-administered questionnaires contained questions related to women’s knowledge regarding the radiation protection measures during dental imaging, the safest period for dental imaging, the type of radiographs that can be acquired during pregnancy, and the possibility of radiation-induced malignancy and fetal malformation as a result of dental imaging. Results In total, 410 completed questionnaires were received and analyzed. More than half of the participants were 30–49 years of age. The majority of the participants (91%) demonstrated poor knowledge concerning dental imaging. Only 4% reported that pregnant women can have dental imaging during any trimester. The majority believed that panoramic images and cone-beam computed tomography should not be acquired during pregnancy. The majority also believed there is a high risk of congenital malformation due to dental imaging and were unsure about the oncogenic risks. Conclusions Our study suggests that there is insufficient knowledge about dental imaging safety during pregnancy. This misconception may have a direct impact on the attitude toward seeking dental care. Therefore, community awareness initiatives aimed at informing our society about radiation exposure, safety, and required protection measures are critical. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01726-6.
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Moghimi P, Hajimiri K, Saghatchi F, Rezaeejam H. ASSESSMENT OF THE AWARENESS LEVEL OF RADIATION PROTECTION AMONG RADIOGRAPHERS WORKING IN THE MEDICAL IMAGING WARDS OF THE HOSPITALS IN ZANJAN, IRAN. RADIATION PROTECTION DOSIMETRY 2021; 194:97-103. [PMID: 34128525 DOI: 10.1093/rpd/ncab088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/29/2021] [Accepted: 05/19/2021] [Indexed: 06/12/2023]
Abstract
X-ray usage in medical diagnosis could have hurtful effects for both patient and medical imaging wards' personnel as a result of failure to follow radiation protection (RP) principles (shielding, distance and time) by radiographers. This cross-sectional descriptive-analytical study was carried out by valid and reliable online questionnaire, which was completed by 103 radiographers. Data were analyzed by using descriptive statistics (mean, standard deviation and frequency) and analytical statistics (Pearson's correlation coefficient test, Student's independent t-test and analysis of variance test) in the Statistical Package for Social Sciences version 20 (sig: P < 0.05). The study's response rate was 67.32%. The mean scores of participants' total, RP and device knowledge were 42.76, 42.86 and 42.72 out of 100, respectively. Work experience and age of participants were significantly related to device and total knowledge (P < 0.01). Results revealed an undesirable level of participants' awareness, indicating the necessity of holding training courses, especially for less experienced radiographers.
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Affiliation(s)
- Parastoo Moghimi
- Student Research Committee, School of Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Khadijeh Hajimiri
- Department of Health Education and Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Franak Saghatchi
- Department of Radiology Technology, School of Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hamed Rezaeejam
- Department of Radiology Technology, School of Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran
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Duarte ML, dos Santos LR, Oliveira ASB, Iared W, Peccin MS. Computed tomography with low-dose radiation versus standard-dose radiation for diagnosing fractures: systematic review and meta-analysis. SAO PAULO MED J 2021; 139:388-397. [PMID: 34346965 PMCID: PMC9615584 DOI: 10.1590/1516-3180.2020.0374.r3.1902021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 02/19/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Computed tomography (CT) accounts for 13% of all radiological examinations in the United States and 40-70% of the radiation that patients receive. Even with the advent of magnetic resonance imaging (MRI), CT continues to be the gold standard for diagnosing bone fractures. There is uncertainty as to whether CT with a low radiation dose has a fracture detection rate similar to that of standard-dose CT. OBJECTIVE To determine the detection rate of low-dose radiation CT and standard-dose radiation CT for fractures, in patients with suspected fractures. DESIGN AND SETTING Systematic review of comparative studies on diagnostic accuracy within the evidence-based health program at a federal university in São Paulo (SP), Brazil. METHODS We searched the electronic databases Cochrane Library, MEDLINE, EMBASE and LILACS up to June 29, 2020, for studies evaluating the detection rates of low-dose CT and standard-dose CT for diagnosing bone fractures. The Research Triangle Institute (RTI) item bank tool was used for methodological quality evaluation. RESULTS The fracture detection rate according to the number of bones evaluated, using CT with low-dose radiation was 20.3%, while with standard-dose radiation it was 19.2%, and the difference between the methods was not significant. The fracture detection rate according to the number of patients, using CT with low-dose radiation was 56.0%, while with standard-dose radiation it was 58.7%, and this difference between the methods was not significant, either. CONCLUSION CT with low-dose radiation presented detection rates similar to those of CT with standard-dose radiation, regardless of the bones evaluated. REGISTRATION NUMBER CRD42019148491 at the PROSPERO database.
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Affiliation(s)
- Márcio Luís Duarte
- MD, MSc. Musculoskeletal Radiologist, WEBIMAGEM, São Paulo (SP), Brazil; and Doctoral Student in Evidence-based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Lucas Ribeiro dos Santos
- MD, MSc. Endocrinologist and Professor of Physiology and Medical Clinic, Centro Universitário Lusíada (UNILUS), Santos (SP), Brazil; and Doctoral Student in Evidence-based Health Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Acary Souza Bulle Oliveira
- MD, PhD. Afliated Professor, Department of Neurology, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Wagner Iared
- MD, PhD. Supervising Professor, Evidence-Based Health Postgraduate Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Maria Stella Peccin
- PT, PhD. Associate Professor, Department of Human Movement Sciences, and Advisor, Evidence-Based Health Postgraduate Program, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
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Clinical concordance with Image Gently guidelines for pediatric computed tomography: a study across 663,417 CT scans at 53 clinical facilities. Pediatr Radiol 2021; 51:800-810. [PMID: 33404787 DOI: 10.1007/s00247-020-04909-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/07/2020] [Accepted: 11/09/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Managing patient radiation dose in pediatric computed tomography (CT) examinations is essential. Some organizations, most notably Image Gently, have suggested techniques to lower dose to pediatric patients and mitigate risk while maintaining image quality. OBJECTIVE We sought to validate whether institutions are observing Image Gently guidelines in practice. MATERIALS AND METHODS Dose-relevant data from 663,417 abdomen-pelvis and chest CT scans were obtained from 53 facilities. Patients were assigned arbitrary age cohorts with a minimum size of n=12 patients in each age group, for statistical purposes. All pediatric (<19 years old) cohorts at a given facility were compared to the adult cohort by a Kruskal-Wallis test for each of the four scan parameters - (1) x-ray tube kilovoltage (kV), (2) tube-current-by-exposure-time product (tube mAs), (3) scan pitch and (4) tube rotation time - to assess whether the distribution of values in the pediatric cohorts differed from the adult cohort. The same was repeated with volume CT dose index (CTDIvol) and size-specific dose estimate (SSDE) to assess whether pediatric cohorts received less dose than adult cohorts. A P-value of <0.05 was deemed significant. RESULTS Across the 150 pediatric cohorts, 134 had scan parameters that were more child-sized than their adult counterparts. In 128 of these 134 pediatric cohorts, the CTDIvol was less than the adult counterpart. In 111 of these 128 pediatric cohorts, the SSDE was less than the adult counterpart. CONCLUSION The study reaffirms that in practice, Image Gently's suggestions of lowering tube mAs and peak kilovoltage are commonly employed and effective at reducing pediatric CT dose.
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Whitebird RR, Solberg LI, Bergdall AR, López-Solano N, Smith-Bindman R. Barriers to CT Dose Optimization: The Challenge of Organizational Change. Acad Radiol 2021; 28:387-392. [PMID: 32278691 DOI: 10.1016/j.acra.2020.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/19/2020] [Accepted: 02/19/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND The use of diagnostic imaging with computed tomography (CT) has risen significantly, increasing cumulative life-time exposure to ionizing radiation for patients and raising concerns about increased cancer risk. Lowering the doses would reduce concerns about associated cancer risks. PURPOSE To determine organizational leaders' perceptions of barriers to optimizing radiation dose in CT. MATERIALS AND METHODS An observational study using semistructured interviews conducted with 26 organizational leaders from 19 health care systems in the United States, Europe, and Japan. Interviews focused on approaches the organizations used to optimize radiation dose and barriers encountered. Data were analyzed using a directed content analysis approach. RESULTS Analysis identified six primary barriers to dose optimization: (1) resistance to change, (2) limited time and resources, (3) complex organizational structure, (4) lack of leadership support, (5) variations in CT equipment, and (6) variability in CT protocols. CONCLUSION Barriers to optimizing CT dose across diverse health care organizations were described by organizational leaders tasked with implementing and improving CT imaging. They identified six consistent themes that reflected barriers to optimizing radiation dose at the organizational level. These barriers impeded efforts by health care organizations to optimize radiation doses to patients from CT imaging. Identifying barriers early in any improvement process is an important first step in making meaningful and sustained change.
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Colonic stool burden on computed tomography does not correlate with bowel habit: a cross-sectional study. Abdom Radiol (NY) 2021; 46:506-516. [PMID: 32761405 DOI: 10.1007/s00261-020-02689-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/16/2020] [Accepted: 07/25/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Stool burden on abdominal radiographs is not reflective of constipation, perhaps because of variable fecal shadowing or limited inter-rater agreement. These limitations are hypothetically mitigated by computed tomography (CT). This research aimed (i) to evaluate whether bowel movement frequency, stool form, or a diagnosis of functional constipation correlate or associate with stool burden identified on CT, and (ii) to investigate whether physicians use CT in their assessment of a patients' bowel function. METHODS Patients attending for non-emergent abdominal CT imaging were invited to participate by completing a bowel questionnaire. Stool burden identified on imaging was determined and inter-rater reliability was evaluated in a subgroup of patients (n = 20). Descriptive and comparative analyses were performed. An online questionnaire evaluated the use of abdominal imaging in assessing patients' bowel function in a cross-section of ordering physicians. RESULTS The patient response rate was 19% (96/516). No clinically useful associations between fecal burden and stool form, bowel motion frequency, gastrointestinal symptoms or a diagnosis of constipation was identified. The physician response rate was 35% (33/94). Opportunistic use of data was more common than deliberate use. However, an abdominal radiograph or CT scan had been requested by 42% and 18% of physicians respectively to assess patient's chronic bowel habit. Approximately 30% of physicians believed evidence supported this practice. CONCLUSIONS Physicians may use abdominal CT in their assessment of patients' chronic bowel habits. However, objective assessment does not support this practice. Colonic stool burden does not correlate with patient-reported symptoms or a criteria-based diagnosis of constipation.
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Aras S, Tanzer IO, Ikizceli T. A SURVEY STUDY OF RADIATION PROTECTION AWARENESS AMONG RADIOLOGY TECHNICIANS IN MOGADISHU, SOMALIA. RADIATION PROTECTION DOSIMETRY 2020; 192:36-40. [PMID: 33280035 DOI: 10.1093/rpd/ncaa191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/28/2020] [Accepted: 10/23/2020] [Indexed: 06/12/2023]
Abstract
We investigate the ionizing radiation exposure awareness and subject matter knowledge among clinical radiology technicians working in state and private hospitals in Mogadishu, Somalia. Research data are collected via face to face interviews with a prepared questionnaire performed between April and May 2018 in Mogadishu, Somalia. A total of 61 clinical radiology technicians working in 10 state and private hospitals in Mogadishu volunteered to be part of this study. Among the participants, awareness of the harmful effects of ionizing radiation and sufficient subject matter knowledge were lacking. In addition, radiation protection equipment during radiological examinations were not adequately used by clinical radiology technicians. Our results indicate a necessity to retrain and improve the technician education curriculum before and after graduation to create a safer environment both for hospital staff and patients during radiological examinations.
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Affiliation(s)
- Serhat Aras
- Medical Imaging Techniques Programme, University of Health Sciences Turkey, Tibbiye Cad. No:38, 34668, Uskudar, Istanbul, Turkey
| | - Ihsan Oguz Tanzer
- Biomedical Technology Programme, University of Health Sciences Turkey, Tibbiye Cad. No:38, 34668, Uskudar, Istanbul, Turkey
| | - Turkan Ikizceli
- Haseki Training and Research Hospital Radiology Department, University of Health Sciences Turkey, Adnan Adivar Cad, 34130 Fatih, Istanbul, Turkey
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Armbruster M, Koliogiannis V. [The (severely) injured pregnant patient from the perspective of radiology]. Unfallchirurg 2020; 123:928-935. [PMID: 33064161 DOI: 10.1007/s00113-020-00885-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Trauma is one of the leading causes of mortality in pregnant women and significantly increases the likelihood of an unwanted termination of pregnancy. Particularly in severe trauma with an increased risk of significant maternal injuries, computed tomography (CT) remains the imaging modality of choice as it is comprehensively available, quick to carry out and has a high diagnostic accuracy in the detection and classification of life-threatening trauma-associated pathologies compared to other imaging techniques. Considering the radiation-associated risks, it is unlikely that a single, monophasic CT in the emergency trauma room will exceed the threshold of deterministic radiation damage; therefore, fetal malformations or fetal loss are not to be expected; however, there is a low stochastic risk for the delayed occurrence of radiation-induced cancer both for the child and the mother that can be considered small in comparison to missed or delayed diagnoses after severe trauma. Intravenous, nonionic iodinated contrast agents are not contraindicated during pregnancy and should be administered whenever their use would also be considered appropriate in a nonpregnant patient; however, unnecessary scans and, if possible, multiple contrast agent phases should be avoided in order to reduce radiation. Magnetic resonance imaging (MRI) has a major role in the subacute setting and constitutes an excellent problem solver for specific questions, such as the evaluation of discoligamentous injuries of the spine. Its use is deemed acceptable at any stage of pregnancy when the required information is considered important for the management of further treatment. Due to potential teratogenic effects of MRI contrast media containing gadolinium on the fetus, including an increased likelihood of fetal loss, they should only be administered with great caution and under strictly defined indications.
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Affiliation(s)
- M Armbruster
- Klinik und Poliklinik für Radiologie, LMU Klinikum München, Marchionistr. 15, 81377, München, Deutschland.
| | - V Koliogiannis
- Klinik und Poliklinik für Radiologie, LMU Klinikum München, Marchionistr. 15, 81377, München, Deutschland
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Abstract
STUDY DESIGN Cross-sectional survey. OBJECTIVE Examine patients' and physicians' estimates of radiation exposure related to spine surgery. SUMMARY OF BACKGROUND DATA Patients are commonly exposed to radiation when undergoing spine surgery. Previous studies suggest that patients and physicians have limited knowledge about radiation exposure in the outpatient setting. This has not been assessed for intraoperative imaging. METHODS A questionnaire was developed to assess awareness/knowledge of radiation exposure in outpatient and intraoperative spine care settings. Patients and surgeons estimated chest radiograph (CXR) equivalent radiation from: cervical and lumbar radiographs (anterior-posterior [AP] and lateral), computed tomography (CT), magnetic resonance imaging (MRI), intraoperative fluoroscopy, and intraoperative CT (O-arm). Results were compared to literature-reported radiation doses. RESULTS Overall, 100 patients and 26 providers completed the survey. Only 31% of patients were informed about outpatient radiation exposure, and only 23% of those who had undergone spine surgery had been informed about intraoperative radiation exposure. For lumbar radiographs, patients and surgeons underestimated CXR-equivalent radiation exposures: AP by five-fold (P < 0.0001) and seven-fold (P < 0.0001), respectively, and lateral by three-fold (P < 0.0001) and four-fold (P = 0.0002), respectively. For cervical CT imaging, patients and surgeons underestimated radiation exposure by 18-fold (P < 0.0001) and two-fold (P = 0.0339), respectively. For lumbar CT imaging, patients and surgeons underestimated radiation exposure by 31-fold (P < 0.0001) and three-fold (P = 0.0001), respectively. For intraoperative specific cervical and lumbar imaging, patients underestimated radiation exposure for O-arm by 11-fold (P < 0.0001) and 22-fold (P = 0.0002), respectively. Surgeons underestimated radiation exposure of lumbar O-arm by three-fold (P = 0.0227). CONCLUSION This study evaluated patient and physician knowledge of radiation exposure related to spine procedures. Underestimation of radiation exposure in the outpatient setting was consistent with prior study findings. The significant underestimation of intraoperative cross-sectional imaging (O-arm) is notable and needs attention in the era of increased use of such technology for imaging, navigation, and robotic spine surgery. LEVEL OF EVIDENCE 4.
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Ten Brinke JG, Slinger G, Slaar A, Saltzherr TP, Hogervorst M, Goslings JC. Increased and unjustified CT usage in paediatric C-spine clearance in a level 2 trauma centre. Eur J Trauma Emerg Surg 2020; 47:781-789. [PMID: 33108476 PMCID: PMC8187214 DOI: 10.1007/s00068-020-01520-z] [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: 06/30/2020] [Accepted: 09/26/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Cervical spine injury after blunt trauma in children is rare but can have severe consequences. Clear protocols for diagnostic workup are, therefore, needed, but currently not available. As a step in developing such a protocol, we determined the incidence of cervical spine injury and the degree of protocol adherence at our level 2 trauma centre. METHODS We analysed data from all patients aged < 16 years suspected of cervical spine injury after blunt trauma who had presented to our hospital during two periods: January 2010 to June 2012, and January 2017 to June 2019. In the intervening period, the imaging protocol for diagnostic workup was updated. Outcomes were the incidence of cervical spine injury and protocol adherence in terms of the indication for imaging and the type of imaging. RESULTS We included 170 children in the first study period and 83 in the second. One patient was diagnosed with cervical spine injury. Protocol adherence regarding the indication for imaging was > 80% in both periods. Adherence regarding the imaging type decreased over time, with 45.8% of the patients receiving a primary CT scan in the second study period versus 2.9% in the first. CONCLUSION Radiographic imaging is frequently performed when clearing the paediatric cervical spine, although cervical spine injury is rare. Particularly CT scan usage has wrongly been emerging over time. Stricter adherence to current protocols could limit overuse of radiographic imaging, but ultimately there is a need for an accurate rule predicting which children really are at risk of injury.
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Affiliation(s)
- Joost G Ten Brinke
- Department of Surgery, Gelre Hospital, Apeldoorn, The Netherlands. .,Trauma Unit, Department of Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, Amsterdam, The Netherlands.
| | | | - Annelie Slaar
- Department of Radiology, Dijklander Ziekenhuis, Hoorn, The Netherlands
| | | | - Mike Hogervorst
- Department of Surgery, Gelre Hospital, Apeldoorn, The Netherlands
| | - J Carel Goslings
- Department of Trauma Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
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Booij R, Budde RPJ, Dijkshoorn ML, van Straten M. Technological developments of X-ray computed tomography over half a century: User's influence on protocol optimization. Eur J Radiol 2020; 131:109261. [PMID: 32937253 DOI: 10.1016/j.ejrad.2020.109261] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/11/2020] [Accepted: 08/27/2020] [Indexed: 12/14/2022]
Abstract
Since the introduction of Computed Tomography (CT), technological improvements have been impressive. At the same time, the number of adjustable acquisition and reconstruction parameters has increased substantially. Overall, these developments led to improved image quality at a reduced radiation dose. However, many parameters are interrelated and part of automated algorithms. This makes it more complicated to adjust them individually and more difficult to comprehend their influence on CT protocol adjustments. Moreover, the user's influence in adapting protocol parameters is sometimes limited by the manufacturer's policy or the user's knowledge. As a consequence, optimization can be a challenge. A literature search in Embase, Medline, Cochrane, and Web of Science was performed. The literature was reviewed with the objective to collect information regarding technological developments in CT over the past five decades and the role of the associated acquisition and reconstruction parameters in the optimization process.
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Affiliation(s)
- Ronald Booij
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, P.O. Box 2240, 3000 CA, The Netherlands.
| | - Ricardo P J Budde
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, P.O. Box 2240, 3000 CA, The Netherlands.
| | - Marcel L Dijkshoorn
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, P.O. Box 2240, 3000 CA, The Netherlands.
| | - Marcel van Straten
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, P.O. Box 2240, 3000 CA, The Netherlands.
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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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Manning BT, Bohl DD, Idarraga AJP, Holmes GB, Lee S, Lin JL, Hamid KS. Patient Knowledge Regarding Radiation Exposure From Foot and Ankle Imaging. Foot Ankle Spec 2020; 13:324-329. [PMID: 31347397 DOI: 10.1177/1938640019865364] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Foot and ankle surgeons routinely prescribe diagnostic imaging that exposes patients to potentially harmful ionizing radiation. It is unclear how well patients understand the radiation to which they are exposed. In this study, 946 consecutive new patients were surveyed regarding medical imaging and radiation exposure prior to their first appointment. Respondents compared the amount of radiation associated with chest X-rays (CXRs) with various types of foot and ankle imaging. Results were compared with actual values of radiation exposure from the published literature. Of 946 patients surveyed, 841 (88.9%) participated. Most had private insurance (82.8%) and a bachelor's degree or higher (60.6%). Most believed that foot X-ray, ankle X-ray, "low dose" foot and ankle computed tomography (CT) scan (alluding to cone-beam CT), and traditional foot and ankle CT scan contain similar amounts of ionizing radiation to CXR. This contradicts the published literature that suggests that the actual exposure to patients is 0.006, 0.006, 0.127, and 0.833 CXR equivalents of radiation, respectively. Of patients who had undergone an X-ray, 55.9% thought about the issue of radiation prior to the study, whereas 46.1% of those undergoing a CT scan considered radiation prior to the exam. Similarly, 35.2% and 27.6% reported their doctor having discussed radiation with them prior to obtaining an X-ray and CT scan, respectively. Patients greatly overestimate the radiation exposure associated with plain film X-rays and cone-beam CT scans of the foot and ankle, and may benefit from increased counseling regarding the relatively low radiation exposure associated with these imaging modalities.Level of Evidence: Level III: Prospective questionnaire.
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Affiliation(s)
- Blaine T Manning
- Department of Orthopaedic Surgery, University of Missouri-Columbia, Columbia, Missouri
| | - Daniel D Bohl
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | | | - George B Holmes
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Simon Lee
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Johnny L Lin
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Kamran S Hamid
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
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Miles A, Evans REC, Halligan S, Beare S, Bridgewater J, Goh V, Janes SM, Navani N, Oliver A, Morton A, Morris S, Rockall A, Taylor SA, the STREAMLINE investigators AboagyeAAgoramoorthyLAhmedSAmadiAAnandGAtkinGAustriaABallSBazariFBeableRBeedhamHBeestonTBharwaniNBhatnagarGBhowmikABlakewayLBluntDBoavidaPBoisferDBreenDBurkeSButawanRCampbellYChangEChaoDChukundahSCollinsBCollinsCContehVCoutureJCrosbieJCurtisHDanielADavisLDesaiKDugganMEllisSEltonCEngledowAEverittCFerdousSFrowAFurneauxMGibbonsNGlynne‐JonesRGogbashianAGourtsoyianniSGreenAGreenLauraGreenLizGrovesAGuthrieAHadleyEHameeduddinAHanidGHansSHansBHigginsonAHoneyfieldLHughesHHughesJHurlLIsaacEJacksonMJallohAJannapureddyRJaymeAJohnsonAJohnsonEJulkaPKalasthryJKarapanagiotouEKarpSKayCKellawayJKhanSKohDLightTLimbuPLockSLockeILokeTLoweALucasNMaheswaranSMallettSMarwoodEMcGowanJMckirdyFMills‐BaldockTMoonTMorganVNasseriSNicholsPNormanCNtalaENunesAObichereAO'DonohueJOlaleyeIOnajobiAO'ShaughnessyTPadhaniAPardoeHPartridgeWPatelUPerryKPigaWPrezziDPriorKPunwaniSPyersJRafieeHRahmanFRajanpandianIRameshSRaoufSReczkoKReinhardtARobinsonDRussellPSargusKScurrEShahabuddinKSharpAShepherdBShiuKSidhuHSimcockISimeonCSmithASmithDSnellDSpenceJSrirajaskanthanRStachiniVStegnerSStirlingJStricklandNTarverKTeagueJThahaMTrainMTulmuntahaSTunariuNvan ReeKVerjeeAWanstallCWeirSWijeyekoonSWilsonJWilsonSWinTWoodrowLYuD. Predictors of patient preference for either whole body magnetic resonance imaging (WB-MRI) or CT/ PET-CT for staging colorectal or lung cancer. J Med Imaging Radiat Oncol 2020; 64:537-545. [PMID: 32410378 PMCID: PMC8425331 DOI: 10.1111/1754-9485.13038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 03/27/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Whole body magnetic resonance imaging (WB-MRI) may be more efficient in staging cancers, but can be harder for patients to tolerate. We examined predictors of patient preference for WB-MRI vs. CT/ PET-CT for staging colorectal or lung cancer. METHODS Patients recruited prospectively to two multicentre trials comparing diagnostic accuracy of WB-MRI with standard staging scans were sent two questionnaires: the first, administered at trial registration, captured demographics, educational level and comorbidities; the second, administered after staging completion, measured emotional distress (GHQ-12), positive mood (PANAS), perceived scan burden, patients' beliefs about WB-MRI, and preference for either WB-MRI or CT (colorectal trial), WB-MRI or PET-CT (lung trial). Preference for WB-MRI or CT/ PET-CT was analysed using logistic regression. RESULTS Baseline and post-staging questionnaires were completed by 97 and 107 patients, respectively. Overall, 56/107 (52%) preferred WB-MRI over standard scans and were more likely to have no additional comorbidities, higher positive mood, greater awareness of potential benefits of WB-MRI and lower levels of perceived WB-MRI scan burden. In adjusted analyses, only awareness of potential WB-MRI benefits remained a significant predictor (OR: 1.516, 95% CIs 1.006-2.284, P = 0.047). Knowledge that WB-MRI does not use radiation predicted preference (adjusted OR: 3.018, 95% CIs 1.099-8.288, P = 0.032), although only 45/107 (42%) patients were aware of this attribute. CONCLUSIONS A small majority of patients undergoing staging of colorectal or lung cancer prefer WB-MRI to CT/ PET-CT. Raising awareness of the potential benefits of WB-MRI, notably lack of ionizing radiation, could influence preference.
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Affiliation(s)
- Anne Miles
- Department of Psychological SciencesBirkbeckUniversity of LondonLondonUK
| | - Ruth EC Evans
- Department of Psychological SciencesBirkbeckUniversity of LondonLondonUK
| | - Steve Halligan
- Centre for Medical ImagingUniversity College LondonCharles Bell HouseUK
| | - Sandy Beare
- Cancer Research UKUniversity College London Clinical Trials CentreLondonUK
| | | | - Vicky Goh
- Cancer ImagingSchool of Biomedical Engineering and Imaging SciencesKing’s College LondonStrand, LondonUK
| | - Sam M Janes
- Lungs for Living Research CentreUCL RespiratoryDivision of MedicineUniversity College LondonLondonUK
| | - Neal Navani
- Department of Thoracic MedicineUCLH and Lungs for Living Research CentreUCL RespiratoryUniversity College LondonLondonUK
| | - Alfred Oliver
- Cancer patient representativesc/o National Cancer Research InstituteLondonUK
| | - Alison Morton
- Cancer patient representativesc/o National Cancer Research InstituteLondonUK
| | - Steve Morris
- Research Department of Applied Health ResearchUniversity College LondonLondonUK
| | - Andrea Rockall
- Department of Surgery and CancerImperial College LondonKensington, LondonUK
| | - Stuart A Taylor
- Centre for Medical ImagingUniversity College LondonCharles Bell HouseUK
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Almohiy HM, Hussein K, Alqahtani M, Elshiekh E, Loaz O, Alasmari A, Saad M, Adam M, Mukhtar E, Alelyani M, Alshahrani M, Abuhadi N, Alshumrani G, Almazzah A, Alsleem H, Almohiy N, Alrwaili A, Alam MM, Asiri A, Khalil M, Rawashdeh M, Saade C. Radiologists' Knowledge and Attitudes towards CT Radiation Dose and Exposure in Saudi Arabia-A Survey Study. Med Sci (Basel) 2020; 8:E27. [PMID: 32698332 PMCID: PMC7563332 DOI: 10.3390/medsci8030027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 01/20/2023] Open
Abstract
Computed tomography (CT) is a key imaging technique in diagnostic radiology, providing highly sensitive and specific information. While its use has increased dramatically in recent years, the quantity and associated risks of radiation from CT scans present major challenges, particularly in paediatrics. The fundamental principles of radiation protection require that radiation quantities be as low as reasonably achievable and CT use must be justified, particularly for paediatric patients. CT radiation knowledge is a key factor in optimising and minimising radiation risk. The objective of this study was to analyse knowledge level, expertise, and competency regarding CT radiation dose and its hazards in paediatrics among radiologists in Saudi Arabian hospitals. A self-reported, multiple-choice questionnaire assessed the attitudes and opinions of radiologists involved in imaging studies using ionising radiation. Among the total respondents, 65% ± 13.5% had a good comprehension of the dangers of carcinogenicity to the patient resulting from CT scans, with 80% presuming that cancer risks were elevated. However, only 48.5%, 56.5%, and 65% of the respondents were aware of specific radiation risks in head, chest, and abdominal paediatric examinations, respectively. Regular, frequent, and specific training courses are suggested to improve the fundamental knowledge of CT radiation among radiologists and other physicians.
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Affiliation(s)
- Hussain M Almohiy
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Khalid Hussein
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
- Department of Medical Physics and Instrumentation, National Cancer Institute, University of Gezira, Wad Medani 20, Sudan
| | - Mohammed Alqahtani
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Elhussaien Elshiekh
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
- Radiation Safety Institute, Sudan Atomic Energy Commission, Khartoum 1111, Sudan
| | - Omer Loaz
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Azah Alasmari
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Mohamed Saad
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
- Faculty of Science, Department of Physics, Mansoura University, Mansoura 35516, Egypt
| | - Mohamed Adam
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Emad Mukhtar
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Magbool Alelyani
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Madshush Alshahrani
- Department of Radiology, Khamis Mushayt General Hospital, Khamis Mushayt 62457, Saudi Arabia;
| | - Nouf Abuhadi
- Diagnostic Radiology Department, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia;
| | - Ghazi Alshumrani
- Department of Radiology, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
| | - Alaa Almazzah
- Department of Radiology, Asir Central Hospital, Abha 62523, Saudi Arabia;
| | - Haney Alsleem
- Department of Radiological Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia;
| | - Nadiayah Almohiy
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
| | | | - Mohammad Mahtab Alam
- Department of Basic Medical Sciences, College of Applied medical Sciences, King Khalid University, Abha 61421, Saudi Arabia;
| | - Abdullah Asiri
- Department of Radiological Sciences, College of Applied Medical Sciences, Najran University, Najran 1988, Saudi Arabia; (A.A.); (M.K.)
| | - Mohammed Khalil
- Department of Radiological Sciences, College of Applied Medical Sciences, Najran University, Najran 1988, Saudi Arabia; (A.A.); (M.K.)
| | - Mohammad Rawashdeh
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Charbel Saade
- Department of Medical Imaging Sciences, American University of Beirut Medical Center, Beirut 11-0236, Lebanon;
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Naseri M, Shahsavan M, Salahshour F, Peiman S, Allameh SF, Farzanehfar S, Emami-Ardekani AR, Pouraliakbar H, Abbasi M. EFFECTIVE DOSE FOR RADIOLOGICAL PROCEDURES IN AN EMERGENCY DEPARTMENT: A CROSS-SECTIONAL STUDY. RADIATION PROTECTION DOSIMETRY 2020; 189:63-68. [PMID: 32140712 DOI: 10.1093/rpd/ncaa013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 12/05/2019] [Accepted: 01/15/2020] [Indexed: 06/10/2023]
Abstract
The extent of radiation exposure in emergency settings is not well documented; here, the corresponding effective dose (ED) is provided. In 500 patients admitted in row to the emergency department, ED was compared in patients according to complaints and their visiting physicians. Out of all, 220 patients aged 43.5 ± 22.2 years (admission: 2.0 ± 1.6 days) had at least an imaging. The main reasons for admission were trauma (10.5%) and then orthopedic problems (8.6%). EDs from CT and radiography were 1.66 ± 3.59 and 0.71 ± 1.67 mSv, respectively (from all 2.29 ± 4.12). Patients with abdominal (5.8 ± 5.2 mSv; p < 0.002) and pelvic (12.0 ± 6.3 mSv; p < 0.007) complaints received higher ED from CT and radiography and, also, patients visited by surgeons (7.94 ± 6.9 mSv). CT scan was the main source for ED to patients. Irrespective of the final diagnosis, patients with abdominopelvic complaints and those visited by surgeons are at higher exposure risk.
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Affiliation(s)
- Maryam Naseri
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shahsavan
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Faeze Salahshour
- Department of Radiology, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Peiman
- Department of Internal Medicine, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Farshad Allameh
- Department of Internal Medicine, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Farzanehfar
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Emami-Ardekani
- Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Pouraliakbar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrshad Abbasi
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Dietrich CF, Westerway S, Nolsøe C, Kim S, Jenssen C. Commentary on the World Federation for Ultrasound in Medicine and Biology Project "Incidental Findings". ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:1815-1820. [PMID: 32409233 DOI: 10.1016/j.ultrasmedbio.2020.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/25/2020] [Accepted: 02/03/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Christoph F Dietrich
- Department Allgemeine Innere Medizin (DAIM), Hirslanden Klinik Beau-Site, Salem und Permanence, Bern, Switzerland; Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Sue Westerway
- Centre for Surgical Ultrasound, Dep of Surgery, Zealand University Hospital, Køge Asc Prof, Copenhagen Academy for Medical Education and Simulation (CAMES) University of Copenhagen Denmark
| | - Christian Nolsøe
- Copenhagen Academy for Medical Education and Simulation (CAMES), Ultrasound Section, Department of Gastroenterology, Division of Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Seung Kim
- Seoul National University, Seoul, South Korea
| | - Christian Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg/Wriezen and Brandenburg Institute for Clinical Ultrasound, Neuruppin, Germany
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Alhawas AY, Alaska Y, Almohaimede K, Almushayqih MH, Altassan BK, Homiedan M. To What Extent the Emergency Physicians in Riyadh City Are Aware of Patient Radiation Exposure From Diagnostic Imaging Requested in the Emergency Department. Cureus 2020; 12:e8623. [PMID: 32566434 PMCID: PMC7301442 DOI: 10.7759/cureus.8623] [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] [Indexed: 11/13/2022] Open
Abstract
Introduction Radiological imaging that uses ionizing radiation in emergency departments (EDs) has increased with advances in radiological diagnostic methods. Emergency (ER) physicians’ awareness of the radiation doses and the associated cancer risks that the patients are exposed to was surveyed using a questionnaire. Aims To assess the ER physicians’ awareness of radiation doses associated with the diagnostic imaging and to describe their practice about discussing radiation risk with patients at different hospitals in Riyadh city, Saudi Arabia. Methods A prospective, questionnaire-based observational study was conducted in 2016 among 176 ER physicians at different hospitals in Riyadh city. The percentage knowledge score and the frequency of discussing radiation risk with patients based on responses to three scenarios were rated on a visual analog scale (VAS), where a score of 100 indicated that physicians would always discuss it. Results The overall mean knowledge score was 28% (95% CI: 22-34). None of the studied parameters (gender, experience, country of medical qualification, type of degree, and employment level) showed a significant correlation with the overall awareness of ED physicians about radiation exposure. Over three-quarters of physicians (77%) underestimated the lifetime risk of fatal cancer attributed to a single computed tomography (CT) scan of the abdomen. Majority of physicians (60%) reported never discussing radiation risk with patients. The frequency at which physicians were discussing radiation risk with patients varied greatly depending on the clinical scenario (mean VAS scores between 46 and 82). Conclusions ER physicians of different hospitals in Riyadh city had a varied knowledge about the radiation exposure risks, although overall the perception was inadequate. The physicians should receive education, and the diagnostic imaging request may need to include information on radiation doses and risks.
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Affiliation(s)
- Abdulrahman Y Alhawas
- Radiology and Medical Imaging, College of Medicine, King Saud University, Riyadh, SAU
| | - Yasser Alaska
- Emergency Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | | | | | | | - Majid Homiedan
- Radiology and Medical Imaging, College of Medicine, King Saud University, Riyadh, SAU
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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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Ukkola L, Kyngäs H, Henner A, Oikarinen H. Barriers to not informing patients about radiation in connection with radiological examinations: Radiographers' opinion. Radiography (Lond) 2020; 26:e114-e119. [PMID: 32052758 DOI: 10.1016/j.radi.2019.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/25/2019] [Accepted: 12/05/2019] [Indexed: 12/16/2022]
Abstract
INTRODUCTION In some instances, little knowledge regarding radiological examinations is provided to patients. The purpose was to investigate whether radiographers inform patients about radiation, and if not, the reasons for it. METHODS A questionnaire was sent to radiographers working in the public sector in Northern Finland. Radiographers were asked whether they had informed patients about the radiation dose and risks during the last year. If information was not provided, the reasons for it were investigated using multiple-answer type multiple-choice questions with the option for free text responses. The results were compared between a University Hospital and other departments and between different lengths of work experience. Altogether 174/272 (64%) radiographers responded to the questionnaire; 50% were from the University Hospital and 50% from other departments. RESULTS Altogether 103/174 (59%) respondents did not inform patients about the radiation dose and 93/174 (53%) did not inform them about the associated risks. Regarding a passive approach to dose information, respondents thought that the referrer had already informed the patient (49/103, 48%), information was not needed (51/103, 50%), or it might cause unnecessary fear (47/103, 46%). Reasons for a passive approach to risk information were similar (66/93, 71%; 33/93, 36%; 47/93, 51%, respectively). Regarding the results, there were no differences between the institutions or work experience levels. According to the open question, some radiographers expected patients to ask questions before informing them. Lack of time was rarely mentioned as a reason. CONCLUSION The main reasons for inadequate information were ignorance regarding responsibilities, assumption that information is not needed, and concern about causing unnecessary fear. IMPLICATIONS FOR PRACTICE Education, guidelines specifying responsibilities and contents for information, and easy-access digital educational material for public and professionals are needed.
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Affiliation(s)
- L Ukkola
- Master of University of Applied Sciences, Master of Health Science, Department of Diagnostic Radiology, Oulu University Hospital, POB 50, 90029 OYS, Oulu, Finland.
| | - H Kyngäs
- Department of Nursing Science and Health Administration, University of Oulu, Finland
| | - A Henner
- Oulu University of Applied Sciences, Finland
| | - H Oikarinen
- Department of Diagnostic Radiology, Oulu University Hospital, Finland
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