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如果我们向住院医师普及辐射暴露的潜在影响,他们的 CT 检查申请行为会发生改变吗?来自一家大型学术医学中心的经验。

Will CT ordering practices change if we educate residents about the potential effects of radiation exposure? Experience at a large academic medical center.

机构信息

Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.

出版信息

Acad Radiol. 2011 Nov;18(11):1447-52. doi: 10.1016/j.acra.2011.07.006. Epub 2011 Sep 1.

DOI:10.1016/j.acra.2011.07.006
PMID:21889895
Abstract

RATIONALE AND OBJECTIVES

The aim of this study was to determine if educating residents about the potential effects of radiation exposure from computed tomographic (CT) imaging alters ordering patterns. This study also explored whether referring physicians are interested in radiation education and was an initial effort to address their CT ordering behavior.

MATERIALS AND METHODS

Two to four months after a radiologist's lecture on the potential effects of radiation exposure related to CT scans, urology and orthopedic residents were surveyed regarding the number and types of CT scans they ordered, the use of alternative imaging modalities, and whether they used the lecture information to educate patients.

RESULTS

Twenty-one resident lecture attendants completed the survey. The number of CT scans ordered after the lecture stayed constant for 90% (19 of 21) and decreased for 10% (two of 21). The types of CT scans ordered changed after the lecture for 14% (three of 21). Thirty-three percent (seven of 21) reported increases in alternative imaging after the lecture, including 24% (five of 21) reporting increases in magnetic resonance imaging and 19% (four of 21) reporting increases in ultrasound. Patients directed questions about radiation exposure to 57% (12 of 21); 38% (eight of 21) used the lecture information to educate patients. Referring physicians were interested in the topic, and afterward, other physician groups requested radiation education lectures.

CONCLUSIONS

Most clinicians did not change their CT scan ordering after receiving education about radiation from a radiologist. Radiation education allowed clinicians to discuss CT benefits and risks with their patients and to choose appropriate CT protocols. Referring physician groups are interested in this topic, and radiologists should be encouraged to give radiation lectures to them.

摘要

背景与目的

本研究旨在确定向住院医师传授 CT 成像辐射暴露的潜在影响是否会改变其检查申请模式。本研究还探讨了主治医生是否对辐射教育感兴趣,以及这是否是解决其 CT 检查申请行为的初步尝试。

材料与方法

在放射科医生进行有关 CT 扫描相关辐射暴露潜在影响的讲座后 2-4 个月,对泌尿科和骨科住院医师进行了调查,内容包括他们申请的 CT 扫描数量和类型、是否使用替代成像方式,以及他们是否利用讲座信息对患者进行教育。

结果

21 名参加讲座的住院医师完成了调查。90%(21 名中的 19 名)的住院医师在讲座后申请 CT 扫描的数量保持不变,10%(21 名中的 2 名)的住院医师申请 CT 扫描的数量减少。讲座后,14%(21 名中的 3 名)的住院医师申请的 CT 扫描类型发生了变化。33%(21 名中的 7 名)报告在讲座后增加了替代成像,包括 24%(21 名中的 5 名)增加了磁共振成像,19%(21 名中的 4 名)增加了超声检查。57%(21 名中的 12 名)的患者向住院医师询问了辐射暴露相关问题;38%(21 名中的 8 名)的住院医师利用讲座信息对患者进行了教育。主治医生对这一主题很感兴趣,之后其他医生群体也要求进行辐射教育讲座。

结论

大多数临床医生在接受放射科医生关于辐射的教育后并未改变其 CT 扫描申请模式。辐射教育使临床医生能够与患者讨论 CT 的益处和风险,并选择适当的 CT 方案。主治医生对这一主题感兴趣,应鼓励放射科医生为他们举办辐射教育讲座。

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