Pain Diagnostics and Interventional Care, Sewickley, Pennsylvania, USA
Pain Diagnostics and Interventional Care, Sewickley, Pennsylvania, USA.
Reg Anesth Pain Med. 2021 Jun;46(6):469-476. doi: 10.1136/rapm-2020-102002. Epub 2021 Mar 9.
Interventional pain procedures have increased in complexity, often requiring longer radiation exposure times and subsequently higher doses. The practicing physician requires an in-depth knowledge and evidence-based knowledge of radiation safety to limit the health risks to themselves, patients and healthcare staff. The objective of this study was to examine current radiation safety practices and knowledge among interventional pain physicians and compare them to evidence-based recommendations.
A 49-question survey was developed based on an extensive review of national and international guidelines on radiation safety. The survey was web-based and distributed through the following professional organizations: Association of Pain Program Directors, American Academy of Pain Medicine, American Society of Regional Anesthesia and Pain Medicine, European Society of Regional Anesthesia and Pain Therapy, International Neuromodulation Society, and North American Neuromodulation Society. Responses to radiation safety practices and knowledge questions were evaluated and compared with evidence-based recommendations. An exploratory data analysis examined associations with radiation safety training/education, geographical location, practice type, self-perceived understanding, and fellowship experience.
Of 708 responding physicians, 93% reported concern over the health effects of radiation, while only 63% had ever received radiation safety training/education. Overall, ≥80% physician compliance with evidence-based radiation safety practice recommendations was demonstrated for only 2/15 survey questions. Physician knowledge of radiation safety principles was low, with 0/10 survey questions having correct response rates ≥80%.
We have identified deficiencies in the implementation of evidence-based practices and knowledge gaps in radiation safety. Further education and training are warranted for both fellowship training and postgraduate medical practice. The substantial gaps identified should be addressed to better protect physicians, staff and patients from unnecessary exposure to ionizing radiation during interventional pain procedures.
介入性疼痛治疗程序的复杂性不断增加，通常需要更长的辐射暴露时间，从而导致更高的剂量。执业医师需要深入了解和掌握基于证据的辐射安全知识，以限制其自身、患者和医护人员的健康风险。本研究的目的是检查介入性疼痛医师当前的辐射安全实践和知识，并将其与基于证据的建议进行比较。
根据对辐射安全国家和国际指南的广泛审查，开发了一份包含 49 个问题的调查问卷。该调查采用网络形式，通过以下专业组织进行分发：疼痛项目主任协会、美国疼痛医学学会、美国区域麻醉和疼痛医学学会、欧洲区域麻醉和疼痛治疗学会、国际神经调节学会和北美神经调节学会。对辐射安全实践和知识问题的回答进行了评估，并与基于证据的建议进行了比较。探索性数据分析检查了与辐射安全培训/教育、地理位置、实践类型、自我感知理解和奖学金经验的关联。
在 708 名回应的医师中，93%的人对辐射的健康影响表示担忧，而只有 63%的人接受过辐射安全培训/教育。总体而言，只有 2/15 项调查问题的医师符合基于证据的辐射安全实践建议的比例≥80%。医师对辐射安全原则的了解程度较低，10 项调查问题中没有一项的正确回答率≥80%。
我们发现，在实施基于证据的实践和辐射安全知识差距方面存在不足。需要对 fellowship 培训和毕业后的医学实践进行进一步的教育和培训。为了更好地保护医生、工作人员和患者免受介入性疼痛治疗过程中不必要的电离辐射暴露，应解决已确定的明显差距。
