Knowledge of Radiation Dose and Awareness of Risks: a Cross-sectional Survey of Junior Clinicians
SY Luk, JLY Leung, CS Cheng
Hong Kong J Radiol 2010;13:189-94
Objectives: To investigate among junior clinicians: (1) their level of knowledge and awareness of radiation dose of commonly performed radiological investigations and the associated risks of radiation exposure, and (2) their practice for obtaining informed
consent for examinations involving high-dose radiation.
Methods: A questionnaire dealing targeting knowledge about commonly performed radiological procedures was distributed to clinicians under specialist training in a tertiary hospital. It addressed: (1) relative radiation doses, (2) associated risks of radiation exposure, (3) what they considered when requesting radiological examinations, and (4) their practice of obtaining informed consent for high-dose radiation examinations.
Results: Of 63 respondents, 57% (n = 36) to 90% (n = 57) underestimated the relative radiation dose of commonly performed radiological investigations. In all, 13% (8/63) incorrectly believed that magnetic resonance imaging involved radiation exposure and 5% (3/63) incorrectly believed that ultrasound involved radiation exposure; 98% (62/63) underestimated the 1 in 2000 lifetime risk of developing cancer after computed tomography of the abdomen; 79% (50/63) believed that diagnostic accuracy is the most important factor to consider when requesting radiological examinations; 27% (17/63) stated that they always explain the risks and benefits of radiation exposure to their patients when obtaining informed consent for examinations involving highdose radiation.
Conclusion: This study demonstrated a deficit of knowledge about radiation dose, exposure, and risks among junior clinicians, which may cause them to request more radiological examinations than appropriate and high-dose examinations instead of lower-risk alternatives. Providing better radiation protection training may help improve their basic knowledge on the subject and reduce unnecessary patient exposure to radiation.
中文摘要
年輕醫生對放射劑量的認識及風險認知的橫向調查研究
陸嬈、梁禮賢、鄭志成
目的：探討及了解低年資醫生以下兩方面的情況：（1）對一般放射性檢查中所使用的放射劑量的認識及認知，以及輻射暴露的相對風險；（2）當牽涉高劑量放射性檢查時，對於取得病人知情同意的做法。
方法：給一所三級醫院中正進行專科訓練的低年資醫生發放一份關於一般放射性檢查的問卷。問題圍繞著以下幾方面：（1）相對放射劑量；（2）輻射暴露引起的風險；（3）當要求病人接受放射性檢查時會考慮的事情；（4）當牽涉高劑量放射性檢查時，對於取得病人知情同意的做法。
結果：共63位被訪者中，有57%（36位）至90%（57位）低估了一般放射性檢查中的相對放射劑量。有13%（8位）誤以為磁力共振檢查牽涉輻射暴露；另5%（3位）誤以為超聲波檢查牽涉輻射暴露。對於腹部電腦斷層檢查，98%（62位）低估了其後生命中發生癌症的1/2000風險機率。79%（50位）相信診斷準確性是進行放射性檢查中最重要的考慮因素。
結論：本研究發現低年資醫生對於放射劑量、輻射暴露及風險認知的認識不足，這樣可能會導致他們要求病人進行比實際需要為多的放射性檢查；而當可以使用危險性低的其他檢查時，他們可能會要求進行高劑量放射性檢查。為低年資醫生提供更佳的輻射防護訓練，可以提升他們對此課題的認識，及減少病人不必要的輻射暴露。