Comparison of physicians' knowledge regarding radiation exposure and risks in common radiological investigations - A cross-sectional study

Abstract

Background: Radiations have been proven to increase the risk of cancer, heritable defects, and radiation associated non-cancer diseases. Inappropriately advised radiology investigations can lead to avoidable radiation exposures and expenses. The referring physician is overall responsible to prescribe the most appropriate imaging procedure for the patient clinical condition, by providing supporting data justifying that choice. Clinical Imaging Referral Guidelines (CIGs) have, therefore, been established or adopted in some countries to support the physicians’ referral for the most suitable imaging procedure. However, there is a strong unmet need in advocating acceptance of these guidelines among referring physicians. As most of the investigations are initiated by non-radiologists, it is imperative that they have adequate knowledge of radiation exposure and risks. Radiologists play a key role in locally educating their non-radiology colleagues on the associated radiation imaging hazards. Objectives: The objectives of the study were to compare the knowledge of radiologists and non-radiologists regarding ionizing radiation exposure and risks in common radiological investigations and to increase awareness of risks of various imaging techniques, among non-radiological physicians. Materials and Methods: A total of 200 physicians working in tertiary hospital were enrolled in the study. A pretested questionnaire was prepared and given to the participants after taking their consent. Questionnaire included demographic details and questions relating to radiation exposure during diagnostic imaging. Results: The highest mean correct score in the radiology group was 15.70% (range 11–20) standard deviation (SD) 2.32, while the lowest mean correct score in the non-radiology was 9.56% (range 5–14) SD 2.50 P < 0.001. All other departments except pulmonary medicine, orthopedics and urology department differed significantly in their mean correct scores compared to the radiology department. 19.4% and 16.4%, of non-radiology physicians also wrongly associated (overestimated) magnetic resonance imaging and ultrasound with ionizing radiation, respectively, and 20% were not aware of the radiation dose. Conclusion: Non-radiologists underestimated the real radiation doses, and their knowledge of the risks was inadequate. It may be possible that physicians tend to order more radiological investigations due to increased patient load. Awareness of radiation dose of imaging procedures and their risk to exposure must be increased among all medical professionals. Therefore, training on radiation protection and local adoption of CIGs has become necessary. A large multi-centric nation-based study will not only help in assessing the gaps in knowledge but also help build consensus and encourage adoption of clinical imaging referring guidelines on a national level.