Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
AITRI, Association of Italian Interventional Radiographers, Milan, Italy.
Health Phys. 2019 Jul;117(1):76-83. doi: 10.1097/HP.0000000000001049.
Cardiac interventional practitioners need to be appropriately informed regarding radiation dose quantities and risks. Communicating benefit-risk information to patients requires attention as specified in Basic Safety Standards Directive 2013/59/Eurotom. This study investigated the awareness of procedural radiation dose levels and the impact of personal training experience in communicating ionizing radiation benefit-risks to patients.
A questionnaire, consisting of 28 questions, was distributed directly to adult and pediatric interventional cardiology specialists at specialized cardiovascular imaging centers in Dublin, Ireland and Milan, Italy.
A total of 18 interventional cardiologists (senior registrar to consultant grades with between 2 y to over 21 y experience in cardiac imaging) participated. The majority of participants (n = 17) stated that parents of pediatric and adult patients should be informed of the potential benefits and risk. All participants indicated they had radiation safety training; however, 50% had not received training in radiation examination benefit-risk communication. Despite this, 77.8% (n = 14) participants indicated a high confidence level in successfully explaining risks and/or benefits of cardiac imaging procedures. When asked to estimate effective dose (ED) values for common cardiac imaging procedures less than 50% identified appropriate dose ranges. All participants underestimated procedural dose values based on recent European data. 50% (n = 9) participants answered all questions correctly for a number of true or false radiation risk statements.
Benefit-risk communication training deficits and inaccurate understanding of radiation dose levels was identified. Further research and training to support clinicians using radiation on a daily basis is required.
心脏介入医生需要充分了解辐射剂量和风险。根据 2013/59/Eurotom 基本安全标准指令的规定，向患者传达获益-风险信息需要引起重视。本研究调查了对程序辐射剂量水平的认识以及个人培训经验对向患者传达电离辐射获益-风险的影响。
向爱尔兰都柏林和意大利米兰的专门心血管成像中心的成人和儿科介入心脏病学专家直接分发了一份由 28 个问题组成的问卷。
共有 18 名介入心脏病学家（从高级住院医师到顾问级，在心脏成像方面有 2 年至 21 年以上的经验）参与了研究。大多数参与者（n=17）表示，儿科和成年患者的父母应被告知潜在的获益和风险。所有参与者都表示他们接受过辐射安全培训；然而，50%的人没有接受过辐射检查获益-风险沟通培训。尽管如此，77.8%（n=14）的参与者表示对成功解释心脏成像程序的风险和/或获益有高度的信心。当被要求估计常见心脏成像程序的有效剂量（ED）值时，不到 50%的人确定了适当的剂量范围。所有参与者都根据最近的欧洲数据低估了程序剂量值。50%（n=9）的参与者对一些关于辐射风险的真/假陈述回答正确。
确定了获益-风险沟通培训不足和对辐射剂量水平的理解不准确的问题。需要进一步的研究和培训来支持每天使用辐射的临床医生。
