From the UniSA Allied Health and Human Performance, University of South Australia.
SA Medical Imaging, Women's and Children's Hospital, Adelaide, Australia.
J Patient Saf. 2022 Jan 1;18(1):e115-e123. doi: 10.1097/PTS.0000000000000716.
The use of an anatomical side marker (ASM) on x-rays, be it digital or radiopaque, is an important quality and safety concept within general radiology. Using radiopaque ASMs is best practice, and lack of any ASMs may have dire consequences in terms of patient safety. To date, there have been no systematic reviews investigating the use of ASMs in clinical practice.
A systematic search of electronic databases (CINAHL, the Cochrane Library, Medline, EMBASE, ERIC, and JBI) from inception to March 1, 2018, was undertaken. Gray literature searching (through Google) and pearling was conducted. Methodological quality was assessed using a modified version of the McMaster Critical Appraisal tool for quantitative studies. A customized data extraction tool was developed, which included characteristics of the studies.
Of 624 studies, 7 studies met the eligibility criteria. Despite diverse study designs, collectively, the studies demonstrated that only a small number of x-rays did not include an ASM. On x-rays that did use a radiopaque ASM, most of them were positioned in the primary radiation field. A noticeable shift in practice from the use of radiopaque ASMs to digital ASM was also identified. Multifaceted barriers were reported for the use of ASM in routine clinical practice.
Although missing ASMs on x-rays were a small feature, findings from this review highlight opportunities for improvement and a need to ameliorate barriers for ASM use.
在普通放射科中，X 光片上使用解剖侧标记物（ASM），无论是数字标记物还是放射性标记物，都是一个重要的质量和安全概念。使用放射性 ASM 是最佳实践，如果 X 光片中没有任何 ASM，可能会对患者安全产生严重后果。迄今为止，还没有系统评价调查 ASM 在临床实践中的使用情况。
从创建到 2018 年 3 月 1 日，对电子数据库（CINAHL、Cochrane 图书馆、Medline、EMBASE、ERIC 和 JBI）进行了系统搜索。还进行了灰色文献搜索（通过 Google）和珍珠搜索。使用修改后的 McMaster 定量研究批判性评估工具评估方法学质量。开发了一个自定义的数据提取工具，其中包括研究的特征。
在 624 项研究中，有 7 项符合入选标准。尽管研究设计各不相同，但总的来说，这些研究表明，只有一小部分 X 光片没有包含 ASM。在使用放射性 ASM 的 X 光片中，大多数 ASM 位于主要辐射场中。还发现，在常规临床实践中，使用 ASM 的做法明显发生了转变。报告了多方面的障碍，阻碍了 ASM 在常规临床实践中的使用。
尽管 X 光片中缺少 ASM 是一个小问题，但本综述的结果强调了改进的机会，并需要缓解 ASM 使用的障碍。
