Radiation risks knowledge in resident and fellow in paediatrics: a questionnaire survey
Tóm tắt
Analyse through a multi-choice anonymous questionnaire the knowledge’s level in paediatric residents and fellows in two different main Italian hospital, looking mainly to the information to patients and relatives related to risks of ionizing radiation used in common radiological investigations in children. 65 multi choice questionnaires were distributed to paediatric residents and fellows of two different hospitals, an University Hospital (A.O.U.P. “P. Giaccone”- University of Palermo) and a national reference centre for paediatrics (Ospedale Pediatrico Bambino Gesù - Rome). The questionnaire included twelve multiple-choice questions with the aim of analyzing the knowledge about ionizing radiation related risks in infants and children who undergo common diagnostic radiology investigations. The data obtained were processed using software Stata/MP version 11.2. In order to measure the level of expertise of each interviewee a binary indicator was built. The value 1 was assigned if the percentage of correct answers exceeds the median of the distribution and 0 for values not exceeding the median. The association between the level of competence and demographic characteristics (gender, age) and training experience was measured by means of α2 test. 51/65 questionnaires were completed, returned and analysed (87.7%). Only 18 surveyed (35%), (95% IC = [22%-48%]) can be defined as competent in radiation risk knowledge for common radiological investigations, considering the percentage of correct answers at least of 50% (sufficient knowledge was given with a minimum score of 8 correct answers out of 12). The study demonstrates an urgent need to implement the radiation protection knowledge in the training programme of paediatricians, that improve if just a short targeted training is performed.
Tài liệu tham khảo
Larson DB, Johnson LW, Schnell BM, Goske MJ, Salisbury SR, Forman HP. Rising use of CT in child visits to emergency department in the United States, 1995–2008. Radiology. 2011;259(3):793–801.
Linet MS, Kim KP, Rajaraman P. Children’s exposure to diagnostic medical radiation and cancer risk: epidemiologic and dosimetric considerations. Pediatr Radiol. 2009;39 Suppl 1:S4.
IMV Medical Information Division. Benchmark report: CT 2013. Des Plaines, Illinois USA: IMV; 2013.
Golding SJ, Shrimpton PC. Radiation dose in CT: are we meeting the challenge? Br J Radiol. 2002;67:751–4.
Haaga JR. Radiation dose management: weighting risk versus benefit. AJR. 2001;177:289–91.
DIRETTIVA 2013/59/EURATOM DEL CONSIGLIO del 5 dicembre 2013 che stabilisce norme fondamentali di sicurezza relative alla protezione contro i pericoli derivanti dall’esposizione alle radiazioni ionizzanti, e che abroga le direttive 89/618/Euratom, 90/641/Euratom, 96/29/Euratom, 97/43/Euratom e 2003/122/Euratom. http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2014:013:0001:0073:IT:PDF Acessed on 14 march 2015.
Pierce DA, Preston DL. Radiation-related cancer risks at low doses among atomic bomb survivors. Radiat Res. 2000;154:178–86.
Little MP, Hoel DG, Molitor J, Boice JD, Wakeford Muirhead CR. New models for evaluation of radiation-induced lifetime cancer risk and its uncertainty employed in the UNSCEAR 2006 report. Radiat Res. 2008;169:660–76.
Bly R. Dose data med 2. Study on European Population Doses from Medical Exposure http://ddmed.eu/ Accessed 14 March 2015.
Scanff P, Donadieu J, Pirard P, Aubert B. Population exposure to ionizing radiation from medical in France. Br J Radiol. 2008;81:204–13.
Brisse HJ, Aubert B. CT exposure from pediatric MDCT: results from the 2007–2008 SFIPP/ISRN survey. J Radiol. 2009;90:207–15.
Mettler Jr FA, Wiest PW, Locken JA, Kelsey CA. CT scanning: patterns of use and dose. J Radiol Prot. 2000;20:353–9.
Smith-Bindman R. Is computed tomography safe? N Engl J Med. 2010;363:1–4.
Granata C, Origgi D, Palorini F, Matranga D, Salerno S. Radiation dose from multidetector CT studies in children: results from the first Italian nationwide survey. Pediatr Radiol. 2014; doi:10.1007/s00247-014-3201-z.
Stemberg S. Us Today 2001 http://usatoday30.usatoday.com/news/nation/2001-01-22-scans.htm Accessed 14 March 2014.
Busey JM, Soine LA, Yager JR, Choi EShuman WP. Patient knowledge and understanding of radiation from diagnostic imaging. JAMA Intern Med. 2013;173:239–41.
Thomas KE, Parnell-Parmley JE, Haidar S, Moineddin R, Charkot E, BenDavid G, et al. Assessment of radiation dose awareness among paediatrician. Pediatr Radiol. 2006;36:823–32.
Günalp M, Gülünay B, Polat O, Demirkan A, Gürler S, Akkaş M, et al. Ionising radiation awareness among resident doctors, interns, and radiographers in a university hospital emergency department. Radiol Med. 2014;119:440–7.
Goske MJ. Doctor, is a CT scan safe for my child? Br J Radiol. 2014;87:20130517.
Miglioretti DL, Johnson E, Williams A, Greenlee RT, Weinmann S, Solberg LI, et al. The use of Computed Tomography in Pediatrics and the Associated Radiation Exposure and Estimated Cancer Risk. JAMA Pediatr. 2013;167:700–7.
Pearce MS, Salotti JA, Little MP, McHugh K, Lee C, Kim KP, et al. Berrington de Gonzalez A. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet. 2012;380:499–505.
Mathews JD, Forsythe AV, Brady Z, Butler MW, Goergen SK, Byrnes GB, et al. Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ. 2013;346:f2360.
Chodick G, Ronckers C, Ron E, Shalev V. The utilization of pediatric computed tomography in a large Israeli Health Maintenance Organization. Pediatr Radiol. 2006;36:485–90.
Menoch MJ, Hirsch DA, Khan NS, Simon HK, Sturm JJ. Trends in computed tomography utilization in the paediatric emergency department. Pediatrics. 2012;129:690–7.
Budoff M. Cardiac CT: benefits outweigh the risks. J Cardiovasc Comput Tomogr. 2011;5:275–6.
DECRETO LEGISLATIVO 9 maggio 2001, n 257.: Disposizioni integrative e correttive del decreto legislativo 26 maggio 2000, n.241, recante attuazione della direttiva 96/29/Euratom in materia di protezione sanitaria della popolazione e dei lavoratori contro i rischi derivanti dalle radiazioni ionizzanti. http://www.gazzettaufficiale.it. Accessed 14 March 2015.
Puri S, Hu R, Quazi RR, Voci S, Veazie P, Block R. Physicians’ and midlevel providers’ awareness of lifetime radiation attributable cancer risk associated with commonly performed CT studies: relationship to practice behavior. AJR Am J Roentgenol. 2012;199:1328–36.
Gower-Thomes K, Lewis MH, Shiralkar S, Snow M, Galland RB, Rennie A. Doctors’ knowledge of radiation exposures is deficient. BMJ. 2002;324:919.
Royal College of Radiologists and National Radiological Protection Board. Patient dose reduction in diagnostic radiology. Documents of the National Radiological Protection Board 1990;1: No 3.
Foley SJ, Evanoff MJ, Rainford LA. A questionnaire survey reviewing radiologists’and clinical specialist radiographers’ knowledge of CT exposure parameters. Insights Imaging. 2013;4:637–46.
Carpeggiani C, Kraft G, Caramella D, Semelka R, Picano E. Radioprotection (un)awareness in cardiologists, and how to improve it. Int J Cardiovasc Imaging. 2012;28(6):1369–74.
Walshe TM, Donagh C, Browne AM. Junior doctors’ knowledge of patient and staff radiation dose exposure and associated risks [abstract]. S819 RSNA, 29nov-4dic 2009; Chicago (USA).
Soye JA, Paterson A. A survey of awareness of radiation dose among health professionals in Northern Ireland. Br J Radiol. 2008;81:725–9.
Heyer CM, Hansmann J, Peters SA, Lemburg SP. Paediatrician awareness of radiation dose and inherent risks in chest imaging studies–a questionnaire study. Europ J Radiol. 2010;76:288–93.
Krille L, Hamer GP, Merzenich H, Zeeb H. Systematic review on physician’s knowledge about radiation doses and radiation risks of computed tomography. Europ J Radiol. 2010;76:36–41.
Brink JA, e Amis e. Image wisely: a campaign to increase awareness about adult radiation protection. Radiology. 2010;257:601–2.
Strain JD. ACR appropriateness criteria on headache-child. J Am Coll Radiol. 2007;4:18–23.
Lee CL, Haims AH, Monico EP, Brink JA, Forman HP. Diagnostic CT scans: assessment of patient, physician and radiologist awareness of radiation dose and possible risks. Radiology. 2004;231:393–8.
Rehani MM, Berris T. International Atomic Energy Agency study with referring physicians on patient radiation exposure and its tracking: a prospective survey using a web-based questionnaire. BMJ. 2012;20:2.