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从战壕中看问题:第 2 部分-EPR 筛选的技术考虑因素。

The view from the trenches: part 2-technical considerations for EPR screening.

机构信息

EPR Center for Viable Systems, Dartmouth Medical School, Hanover, NH 03755, USA.

出版信息

Health Phys. 2010 Feb;98(2):128-35. doi: 10.1097/01.HP.0000348461.00071.10.

Abstract

There is growing awareness of the need for methodologies that can be used retrospectively to provide the biodosimetry needed to carry out screening and triage immediately after an event in which large numbers of people have potentially received clinically significant doses of ionizing radiation. The general approach to developing such methodologies has been a technology centric one, often ignoring the system integrations considerations that are key to their effective use. In this study an integrative approach for the evaluation and development of a physical biodosimetry technology was applied based on in vivo electron paramagnetic resonance (EPR) dosimetry. The EPR measurements are based on physical changes in tissues whose magnitudes are not affected by the factors that can confound biologically-based assessments. In this study the use of a pilot simulation exercise to evaluate an experimental EPR system and gather stakeholders' feedback early on in the development process is described. The exercise involved: ten non-irradiated participants, representatives from a local fire department; Department of Homeland Security certified exercise evaluators, EPR experts, physicians; and a human factors engineer. Stakeholders were in agreement that the EPR technology in its current state of development could be deployed for the screening of mass casualties. Furthermore, stakeholders' recommendations will be prioritized and incorporated in future developments of the EPR technique. While the results of this exercise were aimed specifically at providing feedback for the development of EPR dosimetry for screening mass casualties, the methods and lessons learned are likely to be applicable to other biodosimetric methods.

摘要

人们越来越意识到需要采用能够回溯的方法,以便在大量人群可能受到临床显著剂量电离辐射的事件发生后,立即提供所需的生物剂量测定。开发此类方法的一般方法一直是一种以技术为中心的方法,往往忽略了对其有效使用至关重要的系统集成考虑因素。在这项研究中,应用了一种基于体内电子顺磁共振(EPR)剂量测定的综合方法来评估和开发物理生物剂量测定技术。EPR 测量基于组织的物理变化,其大小不受可能干扰基于生物学评估的因素的影响。在这项研究中,描述了使用试点模拟练习来评估实验 EPR 系统并在开发过程早期收集利益相关者反馈的情况。该练习涉及:十名未辐照的参与者,当地消防部门的代表;经国土安全部认证的演习评估员、EPR 专家、医生;和一位人为因素工程师。利益相关者一致认为,当前开发阶段的 EPR 技术可用于大规模伤亡人员的筛选。此外,利益相关者的建议将在未来的 EPR 技术发展中进行优先排序和纳入。虽然这项练习的结果专门旨在为大规模伤亡人员的 EPR 剂量测定筛选提供反馈,但所采用的方法和经验教训可能适用于其他生物剂量测定方法。

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