Are we aware of radiation: A study about necessity of diagnostic X-ray exposure

Table 1 Some characteristics of the physicians participating in the study

Characteristic of physicians		n (%)
Medical department of physicians	Internal Medicine	38 (19.5)
	Emergency Medicine	35 (17.9)
	General Surgery	25 (12.8)
	Cardiology	14 (7.2)
	Anesthesiology	12 (6.2)
	Urology	11 (5.6)
	Pulmonology	10 (5.1)
	Orthopedic Surgery	10 (5.1)
	Child and adolescent psychiatry	7 (3.6)
	Neurosurgery	6 (3.1)
	Neurology	6 (3.1)
	Others	18 (9.2)
Age group, yr	24-30	68 (34.9)
	31-40	99 (50.8)
	> 40	28 (14.3)
Medical practice duration, yr	≤ 5	62 (31.8)
	6-10	69 (35.3)
	11-15	28 (14.4)
	>15	36 (18.5)
Degree of physician	Specialist doctor	125 (64.1)
	Research assistant	51 (26.2)
	General practitioner	19 (9.7)
Total		195 (100)

Others: Pediatrics, medical oncology, forensic medical specialist, otolaryngologist, family physician, gynecology and obstetrics, ophthalmology, dermatology, physical therapy, and rehabilitation.

Table 2 Participants' estimates of radiation dose

Radiation dose estimation			n (%)
Standard CT equivalent chest X-ray		10 ×	12 (6.2)
		50 ×	30 (15.5)
		100 ×	75 (38.5)
		500 ×a	53 (27.2)
		1000 ×	25 (12.8)
Comparison of chest X-ray with the daily average amount of radiation in nature (cosmic rays, earth and underground sources, etc.)		1 d	71 (36.4)
		3 d	46 (23.6)
		7 da	34 (17.4)
		15 d	44 (22.6)
Comparison of abdominal and pelvic CT with the daily average amount of radiation in nature (cosmic rays, earth and underground sources, etc.)	6 mo		30 (15.4)
	1 yr		60 (30.8)
	2 yr		65 (33.3)
	4 yra		40 (20.5)
Total			195 (100)

^aCorrect answer. CT: Computed tomography.

Table 3 Patient questions and approach to imaging and consideration of previous computed tomography scans and radiation dose among physicians

Patient questions about radiation and physicians' consideration of previous radiation dose		n (%)
Informing the patient about radiation		94 (48.2)
Patients questioning radiation dose and harm		78 (40.0)
Frequency of patients asking questions about radiation dose and harm	Rarely	26 (13.3)
	Sometimes	44 (22.6)
	Mostly	8 (4.1)
Physicians checking old imaging		180 (91.8)
CT request affected if more than 10 CT scans were performed in the last 2 years		65 (33.3)
Easier CT request if less than 10 CT scans were performed in the last 2 years		64 (32.8)
Physicians affected by the last 2 yr of CT dose seen over the hospital system		130 (66.7)

CT: Computed tomography.

Table 4 Factors affecting computed tomography request

Factors affecting CT requesta	n (%)
Indication (Mandatory requirement)	192 (98.5)
Patient’s age	68 (34.9)
Patient's insistence or request	22 (11.3)
Having a large number of patients	13 (6.7)
Concern about doing malpractice	70 (35.9)
Concern about not being able to diagnose	82 (42.1)

^aA physician was able to give more than one answer. CT: Computed tomography.

Table 5 Requesting computed tomography without clinical indication

Requesting CT without clinical indication		n (%)
CT request without clinical indication		48 (24.6)
Causes of CT request without clinical indication (n = 48)	Patient's insist or request	21 (10.8)
	Having a large number of patients	8 (4.1)
	Worry about doing malpractice	20 (10.3)
	Concern about not being able to diagnose	16 (8.2)
	Desire to complete diagnosis quickly	23 (11.8)
	Length of US and MRI appointment times	14 (7.2)

CT: Computed tomography; US: Ultrasound; MRI: Magnetic resonance imaging.

Table 6 Measures to be taken to prevent computed tomography request without indication

Measures to be taken to prevent CT request without indication	n (%)
Reducing patient demand	85 (43.6)
Educating physicians about CT radiation dose	61 (31.3)
Extending the patient examination time	131 (67.2)
Shortening US and MRI appointment times	23 (11.8)

CT: Computed tomography; US: Ultrasound; MRI: Magnetic resonance imaging.