Docs in the dark on radiation risks in imaging, but a quick briefing lights the way

Hospital-based clinicians are not well-versed in the specifics of radiation exposure and risk to patients sent for imaging, but a brief education session may be all it takes to bring them up to speed.

Such was the case for 232 physicians from multiple departments at the University of Colorado Anschutz Medical Campus (aka “AMC”) in Aurora, Colo., according to a study published online Nov. 1 in the Journal of the American College of Radiology.

Jason B. Hobbs, MD, and co-researchers tested their AMC colleagues on their knowledge of imaging-generated ionizing radiation twice: before and after attending a 15-minute presentation on the topic.

The clinicians who agreed to participate included advanced practice providers as well as faculty members, fellows and residents, and the departments represented included emergency medicine, family medicine, internal medicine and OB/GYN (as well as radiology).

The session offered general information but didn’t directly supply answers to questions on the test.

As a whole, the cohort scored low on the pre-presentation test.

Participants’ understanding of differences between imaging modalities was particularly poor; in fact, prior to the presentation, more than a quarter couldn’t correctly name the modalities that expose patients to ionizing radiation, the authors report.

Other questions, all posed in multiple-choice format, covered such ground as natural background radiation, the linear no-threshold model and up-to-date sources of decision guidance.

A bright spot in the pre-presentation testing: Most participants, 87%, correctly responded that, when deciding on an imaging exam, “answering the clinical question” is the most important consideration when deciding on an imaging exam. (The incorrect choices offered here were “minimizing radiation dose,” “reducing exam expense” and “avoiding ionizing radiation”)

Across the board, scores skyrocketed on the tests administered after the educational briefing, the authors show.

Not surprisingly, radiologists had the best pre-presentation scores—but even they improved their marks after sitting through the session.

“Efforts to educate ordering providers about radiation exposure and risk are needed to ensure that providers are appropriately weighing the risks and benefits of medical imaging and to ensure high-quality, patient-centered care,” Hobbs and co-authors comment. “[R]adiation safety training provided to all physicians likely represents a high-yield intervention in achieving evidence-based and patient-centered care.”