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‘MD’ Doesn’t Guarantee Radiation-Risk Savvy

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Up to a quarter think ultrasound emits ionizing radiation. Up to one fifth think MRI scans do the same. And we’re talking about doctors.

An analysis of 14 papers published from 1996 through 2009 in Germany, the United Kingdom, Canada, Turkey, Israel, and the United States examined how well physicians understood radiation risks. The verdict: not very well. The findings, by four German researchers, appear in the October issue of the European Journal of Radiology.

In one group of several studies, taken as a whole, only 41 percent of doctors correctly estimated the radiation dosage of CT scans; 28 percent thought it was much lower than it actually was. In one German study, 11 percent of physician participants thought an adult CT exam delivered a smaller dose of radiation than a chest X-ray.

The doctors were even worse at estimating the radiation dosages for children—for whom the risks tend to be greater because they have more years of life ahead in which radiation-induced cancer can develop. Just one third of pediatricians in Germany correctly estimated the radiation dose for children from CT scans, the report said. A little more than half underestimated the dose. In the United Kingdom, only 7 percent correctly estimated the dose.

Two successive local German studies showed small improvements in physicians’ knowledge of radiation risks, the new study’s authors said. Otherwise, the authors did not observe any general trends.

The authors did acknowledge limitations in their new study. The papers on which it was based differed too widely for them to be easily compared, and the authors noted that the new study was not a meta-analysis.

“The overall relatively poor results concerning knowledge of radiation exposure and risk awareness are difficult to interpret,” the new study says. “No trends over time were discernible in any country but Germany. All other successive surveys were not conducted in the same region and differed in terms of methodology, limiting comparability. The findings must therefore be interpreted with caution and may only be seen as rough indicators for medical CT-related practice.”

Still, the results are, at a minimum, disturbing. E. Stephen Amis, MD, chair of the American College of Radiology’s Task force on Radiation Exposure in Medicine, told DOTmed News that the new study probably reflected the true state of radiation-risk knowledge among U.S. physicians.

“I thought perhaps the physicians from the papers overseas would be more knowledgeable, but I guess we have an educational hill in front of us for all physicians to make sure they understand it better,” he said.

The American College of Radiology, the Radiological Society of North America, the American Association of Physicists in Medicine, and the American Society of Radiologic Technologists are planning a big promotional push for their new Image Wisely campaign, an adult counterpart to the Image Gently campaign that urges health-care professionals to limit radiation exposure in children.

“I really think in the next few years, it’s going to be rare to find a radiologist who doesn’t know much about it,” Dr. Amis told DOTmed News, “and hopefully there’ll be fewer referring physicians … who don’t understand the basics.”

Related seminar: Radiology Review

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