Radiation Protection of Patients Unit, International Atomic Energy Agency, Vienna, Austria.
Earlham College, Richmond, IN, United States of America.
J Radiol Prot. 2022 May 9;42(2). doi: 10.1088/1361-6498/ac6047.
The purpose of this IAEA-coordinated international study was to understand aspects related to the communication of radiation risk from imaging studies, such as how often imaging department personnel and referring physicians are asked about radiation risks in diagnostic imaging, who asks about these risks, how often professionals are able to provide satisfactory answers using qualitative metrics and how often quantitative risk estimates are needed. A web-based questionnaire with ten questions was completed by 386 healthcare professionals from 63 countries from all four continents, including clinicians/referring physicians (42.5%), radiologists or nuclear medicine physicians (26.7%), medical physicists (23.1%), radiographers/radiological technologists (6.2%) and others (1.6%). The results indicate that radiation risk-related questions are largely asked by patients (73.1%) and parents of child patients (38.6%), and 78% of the professionals believe they are able to answer those questions using qualitative metrics such as very small/minimal, small, medium rather than number of cancers likely occurring. The vast majority, with over three times higher frequency, indicated the purpose of knowing previous radiological exams as 'both clinical information and radiation exposure history' rather than 'only clinical information'. Nearly two-thirds of the clinicians/referring physicians indicated that knowing the radiation exposure history of the patient will affect their decision-making for the next exam, as against only about one-fifth who said 'no, it will not affect their decision-making'. The same question, when addressed to radiologists, resulted in a slightly larger fraction of about three-quarters who said 'yes', as opposed to a smaller fraction of about 12% who said 'no, it will not affect their decision-making'. Mapping the present situation of communication of benefits and risks for patients is important and may be the basis of further analysis, regular monitoring and possibly a target for clinical audits. Further studies focused on specific professional groups might help in obtaining á deeper understanding of the need for practical communication tools.
本项由国际原子能机构协调的国际研究旨在了解与影像学研究辐射风险沟通相关的方面，例如影像学部门人员和转诊医师在多大程度上被问及诊断影像学中的辐射风险、谁询问这些风险、专业人员使用定性指标提供满意答案的频率以及需要定量风险估计的频率。来自四大洲 63 个国家的 386 名医疗保健专业人员完成了一份包含 10 个问题的网络问卷调查，其中包括临床医生/转诊医师（42.5%）、放射科医师或核医学医师（26.7%）、医学物理学家（23.1%）、放射技师/放射技术人员（6.2%）和其他人员（1.6%）。结果表明，与辐射风险相关的问题主要由患者（73.1%）和儿童患者的家长（38.6%）提出，78%的专业人员认为他们能够使用定性指标（如非常小/极小、小、中）来回答这些问题，而不是用可能发生的癌症数量来回答。绝大多数人（频率高出三倍以上）表示了解之前的影像学检查的目的是“既有临床信息又有辐射暴露史”，而不是“仅有临床信息”。近三分之二的临床医生/转诊医师表示，了解患者的辐射暴露史将影响他们对下一次检查的决策，而只有大约五分之一的人表示“不会，这不会影响他们的决策”。当向放射科医师提出同样的问题时，约有四分之三的人表示“是”，而表示“否，这不会影响他们的决策”的人略多，约为 12%。对目前为患者沟通获益和风险的情况进行描绘很重要，可能是进一步分析、定期监测和可能的临床审计的基础。进一步针对特定专业群体的研究可能有助于更深入地了解对实用沟通工具的需求。
