Journal club: How radiation exposure histories influence physician imaging decisions: a multicenter radiologist survey study.
AJR Am J Roentgenol
; 200(6): 1275-83, 2013 Jun.
Article
en En
| MEDLINE
| ID: mdl-23701064
ABSTRACT
OBJECTIVE:
The purpose of this article is to evaluate the influence of patient radiation exposure histories on radiologists' imaging decisions. MATERIALS ANDMETHODS:
We conducted a physician survey study in three academic medical centers. Radiologists were asked to make an imaging recommendation for a hypothetical patient with a history of multiple CT scans. We queried radiologists' decision making, evaluating whether they incorporated cancer risks from previous imaging, reported acceptance (or rejection) of the linear no-threshold model, and understood linear no-threshold model implications in this setting. Consistency between radiologists' decisions and their linear no-threshold model beliefs was evaluated; those acting in accordance with the linear no-threshold model were expected to disregard previously incurred cancer risks. A Fisher exact test was used to verify the generalizability of results across institutions and training levels (residents, fellows, and attending physicians).RESULTS:
Fifty-six percent (322/578) of radiologists completed the survey. Most (92% [295/322]) incorporated risks from the patient's exposure history during decision making. Most (61% [196/322]) also reported acceptance of the linear no-threshold model. Fewer (25% [79/322]) rejected the linear no-threshold model; 15% (47/322) could not judge. Among radiologists reporting linear no-threshold model acceptance or rejection, the minority (36% [98/275]) made decisions that were consistent with their linear no-threshold model beliefs. This finding was not statistically different across institutions (p = 0.070) or training levels (p = 0.183). Few radiologists (4% [13/322]) had an accurate understanding of linear no-threshold model implications.CONCLUSION:
Most radiologists, when faced with patient exposure histories, make decisions that contradict their self-reported acceptance of the linear no-threshold model and the linear no-threshold model itself. These findings underscore a need for educational initiatives.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Dosis de Radiación
/
Pautas de la Práctica en Medicina
/
Tomografía Computarizada por Rayos X
/
Toma de Decisiones
/
Neoplasias Inducidas por Radiación
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
AJR Am J Roentgenol
Año:
2013
Tipo del documento:
Article
País de afiliación:
Estados Unidos