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appropriate use of lower osmolality media, but only 25% of these had developed mechanisms to ensure or increase compliance with those guidelines. Only one respondent (4%) reported that he routinely informs patients of the issues and tradeoffs involved in deciding whether to use lower or higher osmolality media.We conclude that cost is an important factor in physicians' and hospitals' choices of contrast media and that increased attention should be given to defining appropriate procedures to follow when informed consent is obtained for the use of contrast material.

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