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国际原子能机构与转诊医生就患者辐射暴露及其跟踪情况开展的研究:一项使用基于网络问卷的前瞻性调查。

International Atomic Energy Agency study with referring physicians on patient radiation exposure and its tracking: a prospective survey using a web-based questionnaire.

作者信息

Rehani Madan M, Berris Theocharis

机构信息

International Atomic Energy Agency, Radiation Protection of Patients Unit, Vienna International Centre, Vienna, Austria.

出版信息

BMJ Open. 2012 Sep 20;2(5). doi: 10.1136/bmjopen-2012-001425. Print 2012.

Abstract

OBJECTIVES

To assess the following themes among referring physicians: (A) importance of acquiring information about previous diagnostic exposures; (B) knowledge about radiation doses involved, familiarity with radiation units and, age-related radiosensitivity; (C) opinion on whether patients should be provided information about radiation dose and (D) self-assessment of appropriateness of referrals.

DESIGN

A prospective survey using a web-based questionnaire.

SETTING

International survey among referring physicians.

PARTICIPANTS

Referring physicians from 28 countries.

MAIN OUTCOME MEASURES

Knowledge, opinion and practice of the four themes of the survey.

RESULTS

All 728 responses from 28 countries (52.3% from developed and 47.7% from developing countries) indicated that while the vast majority (71.7%) of physicians feel that being aware of history of CT scans would always or mostly lead them to a better decision on referring patients for CT scans, only 43.4% often enquire about it. The majority of referring physicians (60.5%) stated that having a system that provides quick information about patient exposure history would be useful. The knowledge about radiation doses involved is poor, as only one-third (34.7%) of respondents chose the correct option of the number of chest x-rays with equivalence of a CT scan. In total, 70.9% of physicians stated that they do not feel uncomfortable when patients ask about radiation risk from CT scans they prescribe. Most physicians (85.6%) assessed that they have rarely prescribed CT scans of no clinical use in patient management.

CONCLUSIONS

This first ever multinational survey among referring physicians from 28 countries indicates support for a system that provides radiation exposure history of the patient, demonstrates poor knowledge about radiation doses, supports radiation risk communication with patients and mandatory provisions for justification of a CT examination.

摘要

目的

评估转诊医生对以下主题的看法:(A) 获取既往诊断性照射信息的重要性;(B) 对所涉辐射剂量的了解、对辐射单位的熟悉程度以及与年龄相关的辐射敏感性;(C) 关于是否应向患者提供辐射剂量信息的意见;(D) 对转诊适宜性的自我评估。

设计

使用基于网络问卷的前瞻性调查。

背景

针对转诊医生的国际调查。

参与者

来自28个国家的转诊医生。

主要观察指标

调查中四个主题的知识、意见和做法。

结果

来自28个国家的所有728份回复(52.3%来自发达国家,47.7%来自发展中国家)表明,虽然绝大多数(71.7%)医生认为了解CT扫描史通常或大多会使他们在转诊患者进行CT扫描时做出更好的决定,但只有43.4%的医生经常询问这方面情况。大多数转诊医生(60.5%)表示,拥有一个能快速提供患者照射史信息的系统会很有用。对所涉辐射剂量的了解较差,只有三分之一(34.7%)的受访者选择了与一次CT扫描等效的胸部X光片数量的正确选项。总体而言,70.9%的医生表示,当患者询问他们所开CT扫描的辐射风险时,他们并不感到不安。大多数医生(85.6%)评估称,他们在患者管理中很少开具无临床用途的CT扫描。

结论

这项首次针对来自28个国家的转诊医生进行的跨国调查表明,支持建立一个提供患者辐射照射史的系统,显示出对辐射剂量的了解较差,支持与患者进行辐射风险沟通以及对CT检查正当性的强制性规定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e4b/3467637/7041a09a3295/bmjopen2012001425f01.jpg

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