Prospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Jul 20, 2022; 12(4): 264-273
Published online Jul 20, 2022. doi: 10.5662/wjm.v12.i4.264
Are we aware of radiation: A study about necessity of diagnostic X-ray exposure
Erdal Karavas, Bunyamin Ece, Sonay Aydın, Mehmet Kocak, Zeliha Cosgun, Isil Esen Bostanci, Mecit Kantarci
Erdal Karavas, Sonay Aydın, Mecit Kantarci, Department of Radiology, Erzincan University, Erzincan 24142, Turkey
Bunyamin Ece, Department of Radiology, Kastamonu University, Kastamonu 37150, 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, Atatürk University, Erzurum 25240, Turkey
Author contributions: Karavas E, Ece B, and Aydin S participated in design and oversight of the study, and drafted the manuscript; Ece B and Aydin S assisted with data analysis; Kocak M, Cosgun Z, Bostanci I, and Kantarci M participated in design of the study, and was involved in data collection; all authors wrote, read, and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Erzincan University Institutional Review Board (Approval No. E-21142744-805.91-912567).
Informed consent statement: All study participants, or their legal guardian, provided written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that there is no conflict of interest related to the manuscript.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at bunyaminece@hotmail.com. Participants gave informed consent for data sharing and the presented data are anonymized.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement—checklist of items, and the manuscript was prepared and revised according to the CONSORT 2010 statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bunyamin Ece, MD, Assistant Professor, Doctor, Department of Radiology, Kastamonu University, Kuzeykent 57, Alay Street, No. 4, Kastamonu 37150, Turkey. bunyaminece@hotmail.com
Received: January 19, 2022
Peer-review started: January 19, 2022
First decision: March 24, 2022
Revised: March 27, 2022
Accepted: June 3, 2022
Article in press: June 3, 2022
Published online: July 20, 2022
Processing time: 181 Days and 11.3 Hours
ARTICLE HIGHLIGHTS
Research background

Radiation-containing imaging and treatment techniques are frequently used in daily clinical practice. The advancement of technology and clinicians' increased access to radiation-containing examinations also expand the applications of radiation-containing examinations. Recently, the use of radiation-based medical exams has increased exponentially. The dangers of radiation should be highlighted, and awareness of radiation should be increased.

Research motivation

Radiation is a potential carcinogen. Ionizing radiation exposure can damage DNA, increasing an individual's lifetime risk of developing cancer. Medical exams containing radiation are sometimes unnecessary and overused. Preventing unnecessary medical imaging examinations is an option to reduce total exposure to radiation. To avoid unnecessary examinations, it is necessary to understand the demanding process.

Research objectives

To increase radiation awareness and thus reduce unnecessary radiation exposure.

Research methods

We developed a 20-question questionnaire for clinicians to evaluate radiation awareness and the reasons for requesting radiation-containing tests.

Research results

Most of the participants stated that they did not feel sufficient about radiation knowledge and the majority of participants underestimated examination dose rates. Both patients and physicians had a low level of knowledge and awareness about ionizing radiation. In our study, we found that 48.2% of patients were informed about radiation prior to requesting an examination containing ionizing radiation. A large part of the participants (91.8%) reviewed the previous examinations before requesting a radiation-containing examination and that a significant portion (66.7%) would be affected by the high dose warning in the hospital system record. Indication, concern about not being able to diagnose, worry about doing malpractice, high patient density, and the patient's insistence are various factors in requesting a radiation-containing imaging method. Desire to complete diagnosis quickly and fear of malpractice may be the reasons for unindicated computed tomography (CT) demand.

Research conclusions

According to the findings of our study, some solutions can be offered to prevent unnecessary radiation exposure. The first and most critical of these is to raise patients' and clinicians' radiation awareness and consciousness, and to schedule regular radiation training sessions. If the patient's previous radiation exposure and total dose of exposure are displayed as warnings in the patient information system in the hospital before clinicians make a request for a medical exam that includes radiation, this can help reduce unnecessary request and exam repetition. By reducing patient density, doctors can spend more time with the patient rather than rushing to a CT diagnosis, and radiation exposure can be reduced. Additionally, with detailed informed consent to the patient about the potential risks of radiation, the patient's insistence on examination with radiation is reduced, and unnecessary radiation exposure can be prevented.

Research perspectives

Following radiation awareness training for patients and clinicians and the addition of a total radiation dose warning to the hospital's patient information system, prospective studies can be conducted to determine whether the number of requests for radiation-containing examinations has decreased in certain centers.