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儿科医疗服务提供者与放射学检查:关于电离辐射及影像潜在并发症的知识与舒适度

Pediatric providers and radiology examinations: knowledge and comfort levels regarding ionizing radiation and potential complications of imaging.

作者信息

Wildman-Tobriner Benjamin, Parente Victoria M, Maxfield Charles M

机构信息

Department of Radiology, Duke University Hospital, 2301 Erwin Road, Durham, NC, 27710, USA.

Department of Pediatrics, Duke University Hospital, Durham, NC, USA.

出版信息

Pediatr Radiol. 2017 Dec;47(13):1730-1736. doi: 10.1007/s00247-017-3969-8. Epub 2017 Aug 29.

Abstract

BACKGROUND

Pediatric providers should understand the basic risks of the diagnostic imaging tests they order and comfortably discuss those risks with parents. Appreciating providers' level of understanding is important to guide discussions and enhance relationships between radiologists and pediatric referrers.

OBJECTIVE

To assess pediatric provider knowledge of diagnostic imaging modalities that use ionizing radiation and to understand provider concerns about risks of imaging.

MATERIALS AND METHODS

A 6-question survey was sent via email to 390 pediatric providers (faculty, trainees and midlevel providers) from a single academic institution. A knowledge-based question asked providers to identify which radiology modalities use ionizing radiation. Subjective questions asked providers about discussions with parents, consultations with radiologists, and complications of imaging studies.

RESULTS

One hundred sixty-nine pediatric providers (43.3% response rate) completed the survey. Greater than 90% of responding providers correctly identified computed tomography (CT), fluoroscopy and radiography as modalities that use ionizing radiation, and ultrasound and magnetic resonance imaging (MRI) as modalities that do not. Fewer (66.9% correct, P<0.001) knew that nuclear medicine utilizes ionizing radiation. A majority of providers (82.2%) believed that discussions with radiologists regarding ionizing radiation were helpful, but 39.6% said they rarely had time to do so. Providers were more concerned with complications of sedation and cost than they were with radiation-induced cancer, renal failure or anaphylaxis.

CONCLUSION

Providers at our academic referral center have a high level of basic knowledge regarding modalities that use ionizing radiation, but they are less aware of ionizing radiation use in nuclear medicine studies. They find discussions with radiologists helpful and are concerned about complications of sedation and cost.

摘要

背景

儿科医疗服务提供者应了解他们所开具的诊断性影像检查的基本风险,并能自如地与家长讨论这些风险。了解医疗服务提供者的认知水平对于指导相关讨论以及加强放射科医生与儿科转诊医生之间的关系至关重要。

目的

评估儿科医疗服务提供者对使用电离辐射的诊断性影像检查方式的了解程度,并了解他们对影像检查风险的担忧。

材料与方法

通过电子邮件向一所学术机构的390名儿科医疗服务提供者(教员、实习生和中级医疗服务提供者)发送了一份包含6个问题的调查问卷。一个基于知识的问题要求医疗服务提供者指出哪些放射学检查方式使用电离辐射。主观问题询问医疗服务提供者与家长的讨论情况、与放射科医生的会诊情况以及影像检查的并发症。

结果

169名儿科医疗服务提供者(回复率为43.3%)完成了调查。超过90%的回复者正确识别出计算机断层扫描(CT)[1]、荧光镜检查和X线摄影为使用电离辐射的检查方式,而超声和磁共振成像(MRI)为不使用电离辐射的检查方式。较少比例(66.9%正确,P<0.001)的人知道核医学使用电离辐射。大多数医疗服务提供者(82.2%)认为与放射科医生就电离辐射进行讨论是有帮助的,但39.6%的人表示他们很少有时间这样做。医疗服务提供者更关注镇静的并发症和费用,而不是辐射诱发的癌症、肾衰竭或过敏反应。

结论

我们学术转诊中心的医疗服务提供者对使用电离辐射的检查方式有较高的基础知识水平,但他们对核医学检查中电离辐射的使用了解较少。他们认为与放射科医生的讨论是有帮助的,并关注镇静的并发症和费用。

[1] 原文中“computed tomography”缩写为“CT”,翻译时补充了中文全称。

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