scholarly journals Patient understanding of radiation risk from medical computed tomography - A comparison of Hispanic vs. Non-Hispanic Emergency Department populations

2015 ◽  
Author(s):  
Afton McNierney-Moore ◽  
Cynthia Smith ◽  
Jose H. Guardiola ◽  
K Tom Xu ◽  
Peter Richman
Keyword(s):  
Background Radiation ◽  
Radiation Risk ◽  
Good Knowledge ◽  
Independent Effect ◽  
X Rays ◽  
Multivariate Logistic Regression ◽  
Lifetime Cancer Risk ◽  
Convenience Sample ◽  
Medical Testing ◽  
Hispanic Patients

Background: Cultural differences and language barriers may adversely impact patients with respect to understanding the risks/benefits of medical testing. Objective: We hypothesized that there would be no difference in Hispanic vs. non-Hispanic patients’ knowledge of radiation risk that results from CT of the abdomen/pelvis (CTAP). Methods: We enrolled a convenience sample of adults at an inner-city ED. Patients provided written answers to rate agreement on a 10-point scale for two correct statements comparing radiation exposure equality between: CTAP and 5 years of background radiation (question 1); CTAP and 200 chest x-rays (question 3). Patients also rated their agreement that multiple CT scans increase the lifetime cancer risk (question 2). Scores of > 8 were considered good knowledge. Multivariate logistic regression analyses were performed to estimate the independent effect of the Hispanic variable. Results: 600 patients in the study group; 63% Hispanic, mean age 39.2 +/- 13.9 years. Hispanics and non-Hispanics whites were similar with respect to good knowledge-level answers to question 1 (17.3 vs 15.1%; OR=1.2; 95 % CI=0.74- 2.0), question 2 (31.2 vs. 39.3%; OR=0.76; 95% CI=0.54 - 1.1), and question 3 (15.2 vs. 16.5%; OR =1.1; 95% CI= 0.66 - 1.8). Compared to patients who earned < $20,000, patients with income > $40,000 were more likely to answer question 2 with good knowledge (OR =1.96; 95% CI=1.2 – 3.1). Conclusion: The study group’s overall knowledge of radiation risk was poor, but we did not find significant differences between Hispanic vs. non-Hispanic patients.

scholarly journals Patient understanding of radiation risk from medical computed tomography - A comparison of Hispanic vs. Non-Hispanic Emergency Department populations

2015 ◽  
Author(s):  
Afton McNierney-Moore ◽  
Cynthia Smith ◽  
Jose H. Guardiola ◽  
K Tom Xu ◽  
Peter Richman
Keyword(s):  
Background Radiation ◽  
Radiation Risk ◽  
Good Knowledge ◽  
Independent Effect ◽  
X Rays ◽  
Multivariate Logistic Regression ◽  
Lifetime Cancer Risk ◽  
Convenience Sample ◽  
Medical Testing ◽  
Hispanic Patients

Background: Cultural differences and language barriers may adversely impact patients with respect to understanding the risks/benefits of medical testing. Objective: We hypothesized that there would be no difference in Hispanic vs. non-Hispanic patients’ knowledge of radiation risk that results from CT of the abdomen/pelvis (CTAP). Methods: We enrolled a convenience sample of adults at an inner-city ED. Patients provided written answers to rate agreement on a 10-point scale for two correct statements comparing radiation exposure equality between: CTAP and 5 years of background radiation (question 1); CTAP and 200 chest x-rays (question 3). Patients also rated their agreement that multiple CT scans increase the lifetime cancer risk (question 2). Scores of > 8 were considered good knowledge. Multivariate logistic regression analyses were performed to estimate the independent effect of the Hispanic variable. Results: 600 patients in the study group; 63% Hispanic, mean age 39.2 +/- 13.9 years. Hispanics and non-Hispanics whites were similar with respect to good knowledge-level answers to question 1 (17.3 vs 15.1%; OR=1.2; 95 % CI=0.74- 2.0), question 2 (31.2 vs. 39.3%; OR=0.76; 95% CI=0.54 - 1.1), and question 3 (15.2 vs. 16.5%; OR =1.1; 95% CI= 0.66 - 1.8). Compared to patients who earned < $20,000, patients with income > $40,000 were more likely to answer question 2 with good knowledge (OR =1.96; 95% CI=1.2 – 3.1). Conclusion: The study group’s overall knowledge of radiation risk was poor, but we did not find significant differences between Hispanic vs. non-Hispanic patients.

scholarly journals Radiophobia: 7 Reasons Why Radiography Used in Spine and Posture Rehabilitation Should Not Be Feared or Avoided

Dose-Response ◽  
2018 ◽  
Vol 16 (2) ◽  
pp. 155932581878144 ◽  
Author(s):  
Paul A. Oakley ◽  
Deed E. Harrison
Keyword(s):  
Low Dose ◽  
Background Radiation ◽  
Threshold Model ◽  
Radiation Risk ◽  
Biomechanical Analysis ◽  
Cellular Damage ◽  
Imaging Method ◽  
X Rays ◽  
Low Dose Radiation ◽  
Dose Radiation

Evidence-based contemporary spinal rehabilitation often requires radiography. Use of radiography (X-rays or computed tomography scans) should not be feared, avoided, or have their exposures lessened to decrease patient dose possibly jeopardizing image quality. This is because all fears of radiation exposures from medical diagnostic imaging are based on complete fabrication of health risks based on an outdated, invalid linear model that has simply been propagated for decades. We present 7 main arguments for continued use of radiography for routine use in spinal rehabilitation: (1) the linear no-threshold model for radiation risk estimates is invalid for low-dose exposures; (2) low-dose radiation enhances health via the body’s adaptive response mechanisms (ie, radiation hormesis); (3) an X-ray with low-dose radiation only induces 1 one-millionth the amount of cellular damage as compared to breathing air for a day; (4) radiography is below inescapable natural annual background radiation levels; (5) radiophobia stems from unwarranted fears and false beliefs; (6) radiography use leads to better patient outcomes; (7) the risk to benefit ratio is always beneficial for routine radiography. Radiography is a safe imaging method for routine use in patient assessment, screening, diagnosis, and biomechanical analysis and for monitoring treatment progress in daily clinical practice.

scholarly journals Patient Knowledge and Perception of Radiation Risk in Diagnostic Imaging: A Cross-Sectional Study

2019 ◽  
Vol 7 (1) ◽  
pp. 110-115
Author(s):  
Stephen John Sweetman ◽  
Jason Bernard
Keyword(s):  
Informed Consent ◽  
Cancer Risk ◽  
Ionizing Radiation ◽  
Background Radiation ◽  
Information Source ◽  
Radiation Risk ◽  
Patient Knowledge ◽  
X Rays ◽  
X Ray ◽  
Tertiary Center

Background: Informed consent dictates that patients appreciate the risks and benefits of imaging techniques that use ionizing radiation. Computed tomography (CT) and X-ray carry a stochastic lifetime risk of inducing malignancy. This risk is difficult to convey and often overlooked. Objective: This work aims to establish some basics regarding patient knowledge and perception of medical imaging to facilitate an informed consent process. Method: A questionnaire survey was conducted in a general orthopedic outpatient clinic in a United Kingdom tertiary center. Results: There were 219 respondents. Twenty-two percent understood that CT produces ionizing radiation associated with cancer risk, but only 6% knew about cancer risk from natural background radiation. Only 25% knew that CT has a higher cancer risk than X-ray. The majority (93%) knew that smoking poses higher risk than X-rays. The Internet as an information source was statistically associated with concern about X-rays. Conclusions: Patients underestimated CT cancer risk and were unable to compare risk between imaging modalities. Risk can be more effectively conveyed using better known relatable risks as comparators. Patient groups associated with lower knowledge, most in need of education, were highlighted.

Digital x-ray mapping of nanometer-size supported bimetallic catalysts

1988 ◽  
Vol 46 ◽  
pp. 530-531
Author(s):  
L. T. Germinario
Keyword(s):  
Background Radiation ◽  
Metal Cluster ◽  
Single Element ◽  
Beam Diameter ◽  
X Rays ◽  
X Ray ◽  
Major Interest ◽  
Induced Changes

Understanding the role of metal cluster composition in determining catalytic selectivity and activity is of major interest in heterogeneous catalysis. The electron microscope is well established as a powerful tool for ultrastructural and compositional characterization of support and catalyst. Because the spatial resolution of x-ray microanalysis is defined by the smallest beam diameter into which the required number of electrons can be focused, the dedicated STEM with FEG is the instrument of choice. The main sources of errors in energy dispersive x-ray analysis (EDS) are: (1) beam-induced changes in specimen composition, (2) specimen drift, (3) instrumental factors which produce background radiation, and (4) basic statistical limitations which result in the detection of a finite number of x-ray photons. Digital beam techniques have been described for supported single-element metal clusters with spatial resolutions of about 10 nm. However, the detection of spurious characteristic x-rays away from catalyst particles produced images requiring several image processing steps.

scholarly journals The ultraviolet background (intergalactic gas, the Galaxy, and subcosmic rays)

1970 ◽  
Vol 36 ◽  
pp. 341-348
Author(s):  
V. G. Kurt ◽  
R. A. Sunyaev
Keyword(s):  
Interstellar Medium ◽  
Background Radiation ◽  
Neutral Hydrogen ◽  
Exchange Interactions ◽  
List Type ◽  
X Rays ◽  
Intergalactic Gas ◽  
Hydrogen Atoms ◽  
Uv Spectrum ◽  
The Galaxy

(1)Observations. – A survey is made of observations of the background radiation at UV wavelengths from above the atmosphere. Sources of the background radiation and ways of determining the extragalactic component of the background are discussed. Future observations are also discussed.(2)Cosmology. – Limits to the properties of the intergalactic gas follow from observations of the UV background. The problem of detecting galaxies at early stages in their evolution is considered.(3)The Galaxy. – Observations and theoretical estimates are given for the integrated brightness of the Galaxy at UV wavelengths beyond the Lyman-α line. Also discussed are the nature of the Lyman-α emission from the Milky Way and the principal ways of constructing the luminosity function of stars in the Galaxy from observations of the integrated UV spectrum.(4)Subcosmic Rays in the Interstellar Medium. – Fast neutral excited hydrogen atoms can be formed from charge-exchange interactions between subcosmic-ray protons and neutral interstellar gas. Upper limits are given to the energy density of subcosmic rays having E ~ 100 keV.(5)Limits on the Background Radiation in the range <912 Å. – The distribution of neutral hydrogen in the peripheries of galaxies allows limits to be obtained for the flux of metagalactic ionising radiation. The heating and ionisation of the interstellar medium by X-rays is considered.

scholarly journals Competence of senior medical students in diagnosing tuberculosis based on chest X-rays

2010 ◽  
Vol 36 (2) ◽  
pp. 190-196 ◽  
Author(s):  
Vania Maria Carneiro da Silva ◽  
Ronir Raggio Luiz ◽  
Míriam Menna Barreto ◽  
Rosana Souza Rodrigues ◽  
Edson Marchiori
Keyword(s):  
Medical Students ◽  
Rio De Janeiro ◽  
Radiological Diagnosis ◽  
Formal Training ◽  
X Rays ◽  
Emergency Rooms ◽  
Convenience Sample ◽  
School Of Medicine ◽  
Chest X Ray ◽  
The City

OBJECTIVE: To evaluate the competence of senior medical students in diagnosing tuberculosis (TB) based on their reading of chest X-rays, as well as to identify the factors associated with high scores for the overall interpretation of chest X-rays. METHODS: In October 2008, a convenience sample of senior medical students who had undergone formal training in radiology at the Federal University of Rio de Janeiro School of Medicine, in the city of Rio de Janeiro, Brazil, were invited to participate in the study. Six chest X-rays (three of TB patients and three of patients without TB) were selected. Participants were asked to choose one of the three probable radiological interpretations, and one of the four subsequent suitable clinical approaches. They also completed a questionnaire designed to collect data related to demographics, career of interest, time spent in emergency rooms and year of study. The sensitivity and specificity related to competence in the radiological diagnosis of TB, as well as a score for the overall interpretation of chest X-rays, were calculated. RESULTS: The sensitivity of the probable radiological diagnosis of pulmonary TB, based on the three chest X-rays of patients with TB (minimal, moderate and extensive) was 86.5%, 90.4% and 94.2%, respectively, and the specificity was 90%, 82% and 42%. The only factor associated with a high score for the overall radiological interpretation was the year of study. CONCLUSIONS: In this sample of medical students, who had received formal training in radiology early in their medical school course, the competence in interpreting the chest X-rays of TB patients was good. The year of study seems to influence overall chest X-ray reading skill.

scholarly journals Interpretation difficulty of normal versus abnormal radiographs using a pediatric example

2016 ◽  
Vol 7 (1) ◽  
pp. e68-e77 ◽  
Author(s):  
Kathy Boutis ◽  
Stefan Cano ◽  
Martin Pecaric ◽  
T. Bram Welch-Horan ◽  
Brooke Lampl ◽  
...  
Keyword(s):  
Measurement Theory ◽  
Significant Proportion ◽  
X Rays ◽  
Emergency Physicians ◽  
Ossification Centre ◽  
Convenience Sample ◽  
Younger Patient ◽  
History Of ◽  
Patient Variables ◽  
Teaching Files

Background: Radiograph teaching files are usually dominated by abnormal cases, implying that normal radiographs are easier to interpret. Our main objective was to compare the interpretation difficulty of normal versus abnormal radiographs of a set of common pediatric radiographs.Methods: We developed a 234-item digital case bank of pediatric ankle radiographs, recruited a convenience sample of participants, and presented the cases to each participant who then classified the cases as normal or abnormal. We determined and contrasted the interpretation difficulty of the normal and abnormal x-rays items using Rasch Measurement Theory. We also identified case features that were associated with item difficulty.Results: 139 participants (86 medical students, 7 residents, 29 fellows, 5 emergency physicians, and 3 radiologists) rated a minimum of 50 cases each, which resulted in 16,535 total ratings. Abnormal cases were more difficult (+0.99 logits) than were normal ones (-0.58 logits), difference 1.57 logits (95% CI 1.2, 2.0), but there was considerable overlap in difficulty scores. Patient variables associated with a more difficult normal radiograph included younger patient age (β = -0.16, 95% CI -0.22, -0.10), history of distal fibular tenderness (β = 0.55, 95% CI 0.17, 0.93), and presence of a secondary ossification centre (β = 0.84, 95% CI 0.27, 1.41).Conclusions: While abnormal images were more difficult to interpret, normal images did show a range of interpretation difficulties. Including a significant proportion of normal cases may be of benefit to learners.

scholarly journals Assessment of Radiation Risk on Healthcare Workers and Public in & around Two Largest Hospital Campuses of Bangladesh

2021 ◽  
pp. 48-57
Keyword(s):  
Public Health ◽  
Effective Dose ◽  
Healthcare Workers ◽  
Radiation Risk ◽  
Radiation Monitoring ◽  
Radiation Hazard ◽  
Lifetime Cancer Risk ◽  
The Public ◽  
Continuous Radiation ◽  
Yearly Effective Dose

Ionizing radiation gives tremendous benefit to mankind in the hospital through diagnosis and treatment to patients but unnecessary radiation may cause harm to healthcare workers & the public. The purpose of the study is to continuous radiation monitoring in & around the three largest radiological facilities of Bangladesh such as Atomic Energy Centre Dhaka (AECD), Dhaka Medical College Hospital (DMCH) & Bangabandhu Sheikh Mujib Medical University (BSMMU) campuses, and estimation of radiation risk on healthcare workers & public health. Continuous radiation monitoring was performed in & around the AECD, DMCH, BSMMU campuses from August-October 2020 using the Chemiluminescent Dosimeters. The yearly effective doses to healthcare workers and the public due to radiation released from the facilities were ranged from 0.606 ± 0.031 mSv to 0.801 ± 0.0.042 mSv with a mean of 0.707 ± 0.053 mSv. The excess lifetime cancer risk (ELCR) on healthcare workers & public health were evaluated based on the yearly effective dose and ranged from 2.486 Χ 10-3 to 3.287 Χ 10-3 with a mean of 2.900 Χ 10-3. The average yearly effective dose and ELCR on healthcare workers & public health were lower than those of the worldwide permissible values. Continuous radiation monitoring in & around the largest radiological facilities is required for detection of the radiation generating equipment’s malfunctions and improper handling of the radioactive materials. The study would help for minimization of radiation risk on healthcare workers & the public and this keeps the hospital’s environment free from radiation hazard.

scholarly journals LO008: Assessment of the need for diagnostic imaging in extremity injuries by advanced care paramedics

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S32-S33
Author(s):  
P. Froese ◽  
M.B. Butler ◽  
S.G. Campbell ◽  
K. Magee ◽  
R.P. Mackinley
Keyword(s):  
Diagnostic Imaging ◽  
Patient Flow ◽  
Body Part ◽  
Initial Assessment ◽  
X Rays ◽  
Convenience Sample ◽  
Predictive Values ◽  
X Ray ◽  
Subsequent Test ◽  
Extremity Injuries

Introduction: Emergency department (ED) crowding is a national challenge. Initiatives to help address this at our ED include the use of a six-bed fast-track unit staffed by advanced-care paramedics (ACPs). Institutional byelaws only allow diagnostic imaging (DI) ordering by physicians (MD). An ACP requesting DI at the time of first assessment would likely improve patient flow. We investigated whether ACPs can safely and cost-effectively request DI for extremity injuries without increasing cost or exposing patients to unnecessary radiation. Methods: A prospective evaluation of a convenience sample of patients presenting with an extremity injury sustained within 48 hours of presentation. At time of initial assessment, the ACP, following specific guidelines, recorded whether or not they believed an x-ray was indicated, and if so, what DI views they felt appropriate. Their opinion was blinded from the physician subsequently assessing the patient. An ACP opinion of the need for DI was compared with the subsequent test ordered by the MD. The MD decision to order DI was considered ‘gold standard’. Opinions were considered “matched” if the MD ordered DI of the same body part that the ACP believed was indicated. Sensitivity, specificity, positive predictive and negative predictive values (PPV, NPV) were calculated. Using data from our ED information system, we estimated the time that would have been saved by allowing ACPs to order DI. Results: Of 199 patients 192 images were ordered and 89 fractures were diagnosed. ACPs and MDs agreed that DI was necessary 94.70% of the time (95% CI: {90.6%, 97.4%}). There were 8 x-rays the ACP did not order that the MD did order, of which one showed a fracture. Twice, the ACP would have ordered an x-ray that the MD did not. In terms of identifying the need for DI, ACPs were 95.8% sensitive and 71.4% specific. The PPV was 98.9% (95% CI: {95.8%, 99.8%}), and the NPV was 38.5% (95% CI: {15.1%, 67.7%}). On average, ACP opinion of DI indication was made 54.1 minutes (95% CI: {48.0, 60.2}) earlier that of the MD. Conclusion: The overall agreement between MDs and ACPs was almost 95%. ACPs are more likely to under-order x-rays than to over-order them, lowering the risk of increasing radiation exposure and cost. ACP DI ordering may decrease the time of processing of patients with extremity injuries by almost an hour.

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