Of the 171 surveys sent,
a total of 50 doctors completed the survey (response rate 29%).
There were 24 FY1 doctors,
16 FY2 doctors and 10 GP trainees.
Theme 1: Formal teaching on radiation awareness
A total of 20 out of 50 doctors (FY1 n=8,
FY2 n=7 and GPST n=5) had received some form of formal teaching on radiation awareness,
and 60% had never received any teaching on radiation awareness whatsoever Fig. 2.
Fig. 2: This chart demonstrates the percentage of doctors who have received any teaching on radiation awareness during medical school or medical training.
References: Y. Al-Obudi, R. S. Malliwal; London/UK
Theme 2: Estimation of the radiation dose in common radiological investigations
Doctors substantially underestimated the radiation doses in common radiological investigations Fig. 3.
- Only 10% stated the correct dose for abdominal x-ray,
20% for CT head and 12% for CT abdomen/pelvis.
- Only 4% knew the correct dose for a barium swallow and ventilation/perfusion (V/Q) scan.
- 88% of participants underestimated the radiation dose for barium swallow; this was 80% for abdominal x-ray,
68% for CT AP,
68% for V/Q scan and 56% for CT head.
Of the entire population,
24% of participants mistakenly thought that MRI used ionising radiation; and 20% believed ultrasound utilised ionising radiation Fig. 4.
Overall,
there seems to be no significant improvement in radiation awareness with more years of clinical experience Table 2.
Fig. 3: This chart demonstrates the percentage of participants that correctly estimated the radiation doses (in equivalent chest x-rays) for common radiological modalities. It also demonstrates the percentage of participants that underestimated the dose for each modality. AXR = Abdominal x-ray, CTAP = CT abdomen and pelvis, V/Q scan = ventilation/perfusion, US KUB = Ultrasound kidneys, ureters & bladder
References: Y. Al-Obudi, R. S. Malliwal; London/UK
Theme 3: Estimation of radiation-induced cancer risk
The actual estimated risk of inducing fatal malignancy by performing a chest x-ray is 1 in 1 000 000,
an abdominal x-ray 1 in 30 000 and for a CT abdomen/pelvis it is 1 in 2000 [6].
A total of 58% underestimated the lifetime risk of cancer associated with CTAP; this was 48% for abdominal x-ray and 28% for chest x-ray Fig. 5.
For abdominal x-ray,
no participants knew the correct estimated lifetime risk of inducing cancer.
Only 34% knew the correct answer for CTAP,
and 36% for chest x-ray.
Fig. 5: This chart demonstrating the percentage of participants that of correctly estimated or underestimated the lifetime additional risk of fatal cancer per examination. CTAP = CT abdomen and pelvis, CXR = Chest x-ray, AXR = Abdominal x-ray
References: Y. Al-Obudi, R. S. Malliwal; London/UK
Theme 4: Pregnant inquiry prior to radiological investigations
The majority of doctors,
84%,
inquire about pregnancy when requesting a radiological investigation in women of childbearing age.
However,
38% of participants who inquire about pregnancy do this less than 50% of the time Fig. 6.
Fig. 6: A demonstration of how many participants inquire about pregnancy prior to requesting a radiological investigation.
References: Y. Al-Obudi, R. S. Malliwal; London/UK