Communicating radiation risk to patients and referring physicians in the emergency department setting

Shyu, Jeffrey Y.; Sodickson, Aaron

doi:10.1259/bjr.20150868

Cited by 24 publications

(15 citation statements)

References 36 publications

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“…26,31 It could be hypothesized that this communication gap may partly result from a heavy workload in radiological departments, often making it difficult for the radiological staff to provide patients with exhaustive information about radiation exposure. Several studies have highlighted patients' preference to speak directly with imaging experts about their imaging findings, 19,[32][33][34][35] further emphasizing the need for improved direct communication between radiological staff and patients.…”

Section: Jama Network Open | Imagingmentioning

confidence: 99%

Patient Perceptions and Knowledge of Ionizing Radiation From Medical Imaging

et al. 2021

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IMPORTANCE Although imaging has become a standard tool of modern medicine, its widespread use has been paralleled by an increasing cumulative radiation dose to patients despite technological advancements and campaigns calling for better awareness and minimization of unnecessary exposures. OBJECTIVETo assess patients' knowledge about medical radiation and related risks. DESIGN, SETTING, AND PARTICIPANTSA survey study of hospitals in Italy was conducted; all patients in waiting rooms for medical imaging procedures before undergoing imaging examinations at 16 teaching and nonteaching hospitals were approached to take the survey. The survey was performed from June 1, 2019, to May 31, 2020. MAIN OUTCOMES AND MEASURESSurvey respondents' basic knowledge of ionizing radiation levels and health risks, earlier imaging tests performed, and information and communication about radiation protection issues.RESULTS Among 3039 patients invited to participate, the response rate was 94.3% (n = 2866).Participants included 1531 women (53.4%); mean (SD) age was 44.9 (17.3) years. Of the 2866 participants, 1529 (53.3%) were aware of the existence of natural sources of ionizing radiation. Mammography (1101 [38.4%]) and magnetic resonance imaging (1231 [43.0%]) were categorized as radiation-based imaging modalities. More than half of the 2866 patients (1579 [55.1%]; P = .03) did not know that chest computed tomography delivers a larger dose of radiation than chest radiography, and only 1499 (52.3%) knew that radiation can be emitted after nuclear medicine examinations (P = .004). A total of 667 patients (23.3%) believed that radiation risks were unrelated to age, 1273 (44.4%) deemed their knowledge about radiation risks inadequate, and 2305 (80.4%) preferred to be informed about radiation risks by medical staff. A better knowledge of radiation issues was associated with receiving information from health care professionals (odds ratio [OR], 1.71;

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Section: Jama Network Open | Imagingmentioning

confidence: 99%

Patient Perceptions and Knowledge of Ionizing Radiation From Medical Imaging

et al. 2021

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“…For instance, in emergency medicine, a physician has limited knowledge of a patients’ medical history as well as limited time and would be more inclined to choose radiological imaging. 51 When a patient is provided with a choice between “observation” and CT, the patient tendency is to avoid the radiation. 22 However, taking the CT is likely more cost-effective and ethical, for example, for nontraumatic, nonspecific abdominal pain, since it has been shown that a substantial proportion of these patients will continue to suffer, 52,53 even 5-years later.…”

Section: Resistance Of Patients/parents To Receive Radiological Examsmentioning

confidence: 99%

Death of the ALARA Radiation Protection Principle as Used in the Medical Sector

Oakley

Harrison

2020

Dose-Response

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ALARA is the acronym for “As Low As Reasonably Achievable.” It is a radiation protection concept borne from the linear no-threshold (LNT) hypothesis. There are no valid data today supporting the use of LNT in the low-dose range, so dose as a surrogate for risk in radiological imaging is not appropriate, and therefore, the use of the ALARA concept is obsolete. Continued use of an outdated and erroneous principle unnecessarily constrains medical professionals attempting to deliver high-quality care to patients by leading to a reluctance by doctors to order images, a resistance from patients/parents to receive images, subquality images, repeated imaging, increased radiation exposures, the stifling of low-dose radiation research and treatment, and the propagation of radiophobia and continued endorsement of ALARA by regulatory bodies. All these factors result from the fear of radiogenic cancer, many years in the future, that will not occur. It has been established that the dose threshold for leukemia is higher than previously thought. A low-dose radiation exposure from medical imaging will likely upregulate the body’s adaptive protection systems leading to the prevention of future cancers. The ALARA principle, as used as a radiation protection principle throughout medicine, is scientifically defunct and should be abandoned.

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“…16,21 Lack of an understanding of radiation risks jeopardizes effective risk/benefit discussions and undermines the decision process for ordering the CT. 19,21 Studies show that sharing radiation risk information between providers and patients occurs seldomly (<25% cases). 10,16,21,22,25,26 Despite the fact that radiation risk communication occurs rarely, there is evidence to suggest that risk-benefit dialogue with patients could be a valuable tool for decreasing unnecessary CT use in an acute care setting. [27][28][29][30] A recent study revealed that most of the emergency department (ED) providers thought that the CT scans they ordered may have been unnecessary 25% to 50% of the time.…”

Section: Journal Of Medical Education and Curricular Developmentmentioning

confidence: 99%

Maximizing Benefit and Minimizing Risk in Medical Imaging Use: An Educational Primer for Health Care Professions Students

Armao

Hartman

Shea

et al. 2018

Journal of Medical Education and Curricular Development

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“I am not young enough to know everything.”Oscar Wilde Background:There is insufficient knowledge among providers and patients/caregivers of ionizing radiation exposure from medical imaging examinations. This study used a brief, interactive educational intervention targeting the topics of best imaging practices and radiation safety early in health professions students’ training. The authors hypothesized that public health, medical, and physician assistant students who receive early education for imaging appropriateness and radiation safety will undergo a change in attitude and have increased awareness and knowledge of these topics.Materials and methods:The authors conducted a 1.5-hour interactive educational intervention focusing on medical imaging utilization and radiation safety. Students were presented with a pre/postquestionnaire and data were analyzed using t tests and multivariate analysis of variance.Results:A total of 301 students were enrolled in the study. There was 58% (P < .01) and 85% (P < .01) improvement in attitude and knowledge regarding appropriateness of imaging, respectively. The authors also found an 8% increase (P < .01) in students who thought informed consent should be obtained prior to pediatric computed tomographic imaging. Physical assistant students were more likely than medical students to prefer obtaining informed consent at baseline (P = .03).Conclusions:A brief educational session provided to health professions students early in their education showed an increased awareness and knowledge of the utility, limitations, and risks associated with medical imaging. Incorporation of a best imagining practice educational session early during medical education may promote more thoughtful imaging decisions for future medical providers.

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Communicating radiation risk to patients and referring physicians in the emergency department setting

Cited by 24 publications

References 36 publications

Patient Perceptions and Knowledge of Ionizing Radiation From Medical Imaging

Patient Perceptions and Knowledge of Ionizing Radiation From Medical Imaging

Death of the ALARA Radiation Protection Principle as Used in the Medical Sector

Maximizing Benefit and Minimizing Risk in Medical Imaging Use: An Educational Primer for Health Care Professions Students

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