Schuster Angel L, Forman Howard P, Strassle Paula D, Meyer Laura T, Connelly Scott V, Lee Christoph I
Department of Emergency Medicine, Cape Fear Valley Medical Center, 1638 Owen Drive, Fayetteville, NC, 28304, USA.
Department of Radiology and Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, CT, 06510, USA.
Emerg Radiol. 2018 Feb;25(1):41-49. doi: 10.1007/s10140-017-1557-8. Epub 2017 Sep 26.
Using the study design from a prominent 2004 study, we aimed to reassess patient, provider, and radiologist awareness of CT radiation more than a decade later.
Adults presenting to the emergency department of a tertiary care center over a 2-week period with mild to moderate pain requiring an abdominopelvic CT scan were surveyed. Patients were asked if anyone had discussed the risks/benefits of the CT scan including radiation dose and were asked to estimate their dose compared to a chest X-ray. Emergency providers and radiologists were given similar surveys and were asked about potential obstacles to discussing CT radiation with patients.
A total of 101 patients, 570 emergency providers, and 161 radiologists were surveyed. Twenty-three percent (14/61) of patients, 39% (219/568) of emergency providers, and 48% (77/161) of radiologists correctly selected the radiation dose range of an abdominopelvic CT. Seventy-eight percent (441/567) of emergency providers reported routinely discussing radiation dose with patients, while 20% (20/98) of patients reported that their emergency provider discussed radiation dose with them. Time limitation and concern of dissuading the patient from CT were the most commonly reported obstacles for discussing risks.
Patients and providers in 2015 appear to be more aware of radiation dose from CT than they were in 2004. Discussion of CT scan radiation exposure and associated risks only occurs sometimes and may actually occur less frequently than perceived by emergency providers.
采用一项著名的2004年研究的设计,我们旨在在十多年后重新评估患者、医护人员和放射科医生对CT辐射的认知。
对在两周内到三级医疗中心急诊科就诊、因轻至中度疼痛需要进行腹部盆腔CT扫描的成年人进行调查。询问患者是否有人讨论过CT扫描的风险/益处,包括辐射剂量,并要求他们将自己的剂量与胸部X光进行比较估算。对急诊医护人员和放射科医生进行了类似的调查,并询问他们与患者讨论CT辐射的潜在障碍。
共调查了101名患者、570名急诊医护人员和161名放射科医生。23%(14/61)的患者、39%(219/568)的急诊医护人员和48%(77/161)的放射科医生正确选择了腹部盆腔CT的辐射剂量范围。78%(441/567)的急诊医护人员报告经常与患者讨论辐射剂量,而20%(20/98)的患者报告其急诊医护人员与他们讨论过辐射剂量。时间限制和担心劝阻患者进行CT检查是讨论风险时最常报告的障碍。
2015年的患者和医护人员似乎比2004年时更了解CT的辐射剂量。CT扫描辐射暴露及相关风险的讨论只是有时进行,实际发生频率可能低于急诊医护人员的认知。