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Journal club: How radiation exposure histories influence physician imaging decisions: a multicenter radiologist survey study.


ABSTRACT: The purpose of this article is to evaluate the influence of patient radiation exposure histories on radiologists' imaging decisions.We conducted a physician survey study in three academic medical centers. Radiologists were asked to make an imaging recommendation for a hypothetical patient with a history of multiple CT scans. We queried radiologists' decision making, evaluating whether they incorporated cancer risks from previous imaging, reported acceptance (or rejection) of the linear no-threshold model, and understood linear no-threshold model implications in this setting. Consistency between radiologists' decisions and their linear no-threshold model beliefs was evaluated; those acting in accordance with the linear no-threshold model were expected to disregard previously incurred cancer risks. A Fisher exact test was used to verify the generalizability of results across institutions and training levels (residents, fellows, and attending physicians).Fifty-six percent (322/578) of radiologists completed the survey. Most (92% [295/322]) incorporated risks from the patient's exposure history during decision making. Most (61% [196/322]) also reported acceptance of the linear no-threshold model. Fewer (25% [79/322]) rejected the linear no-threshold model; 15% (47/322) could not judge. Among radiologists reporting linear no-threshold model acceptance or rejection, the minority (36% [98/275]) made decisions that were consistent with their linear no-threshold model beliefs. This finding was not statistically different across institutions (p = 0.070) or training levels (p = 0.183). Few radiologists (4% [13/322]) had an accurate understanding of linear no-threshold model implications.Most radiologists, when faced with patient exposure histories, make decisions that contradict their self-reported acceptance of the linear no-threshold model and the linear no-threshold model itself. These findings underscore a need for educational initiatives.

SUBMITTER: Pandharipande PV 

PROVIDER: S-EPMC3970405 | biostudies-literature | 2013 Jun

REPOSITORIES: biostudies-literature

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Journal club: How radiation exposure histories influence physician imaging decisions: a multicenter radiologist survey study.

Pandharipande Pari V PV   Eisenberg Jonathan D JD   Avery Laura L LL   Gunn Martin L ML   Kang Stella K SK   Megibow Alec J AJ   Turan Ekin A EA   Harvey H Benjamin HB   Kong Chung Yin CY   Dowling Emily C EC   Halpern Elkan F EF   Donelan Karen K   Gazelle G Scott GS  

AJR. American journal of roentgenology 20130601 6


<h4>Objective</h4>The purpose of this article is to evaluate the influence of patient radiation exposure histories on radiologists' imaging decisions.<h4>Materials and methods</h4>We conducted a physician survey study in three academic medical centers. Radiologists were asked to make an imaging recommendation for a hypothetical patient with a history of multiple CT scans. We queried radiologists' decision making, evaluating whether they incorporated cancer risks from previous imaging, reported a  ...[more]

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