Have we dropped the ball on radiation safety?

Over the last several years, radiation dose and patient safety have been of particular concern among healthcare providers, particularly with the publication of studies showing that patients were exposed to enough radiation to potentially lead to tens of thousands of future cancer cases.

It's reassuring, then, that the issue is receiving some attention from policy makers and regulators. For example, the Joint Commission, in December, announced changes in its standards for accredited hospitals, critical access hospitals and ambulatory healthcare organizations that provide diagnostic imaging services. Many of the areas addressed in the new and revised standards relate to radiation exposure and patient safety, including annual performance evaluations of imaging equipment by medical physicists, documenting CT radiation dose in patients' clinical records, and collection of data on incidents where pre-identified radiation dose limits have been exceeded.

Congress also stepped in recently with the passage of the latest sustainable growth rate fix legislation (the Protecting Access to Medicare Act), which includes several provisions related to radiation dose, such as for clinical decision support for advanced imaging procedures, mandating improved and stricter radiation dose controls and levels, and requiring that CT equipment meet the National Electrical Manufacturer Association standards.

Despite all those efforts, however, concerns continue to linger. In a recent interview with FierceMedicalImaging, Rita Redberg, editor of JAMA Internal Medicine, lamented the fact that we still aren't doing enough that enough isn't being done to reduce patient exposure to medical radiation.

A new study in Academic Radiology reinforces the idea that we still aren't paying enough attention to the question of radiation dose and patient safety. In the study, out of Emory University's School of Medicine, medical residents across all specialties were surveyed concerning their knowledge and understanding of radiation safety. The results are worrisome.

Even though the residents believed there to be a link between radiation exposure and cancer, many of them--including radiology residents--couldn't demonstrate knowledge related to specific estimated dose effects. For example, just 22 percent of the residents surveyed (and only 29 percent of radiology residents) could estimate the lifetime risk of cancer mortality from a single abdominal CT scan in pediatric patients.

In a 2007 keynote address to the meeting of the National Council on Radiation Protection and Measurements, James Brink, then-chair of diagnostic radiology at the Yale University School of Medicine, said that physicians need more education on the benefits and risk of medical imaging devices using ionizing radiation.

It seems clear that despite the warning from Brink--who now serves as chief of radiology at Massachusetts General Hospital--more still needs to be done. - Mike (@FierceHealthIT)

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