Decision Making and Variation in Radiation Exposure Factor Selection by Radiologic Technologists

Darcy, Sarah; Rainford, Louise; Kelly, Brendan; Toomey, Rachel

doi:10.1016/j.jmir.2015.09.003

Cited by 5 publications

(8 citation statements)

References 26 publications

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“…Participants often questioned the rationale for the imaging request, asking for the clinical history, symptoms and pathological queries of the phantom patient. This highlights the deeply ingrained principle of justification in the use of ionising radiation and reinforces the importance of contextual considerations in radiographic decision‐making identified in this study, which should be considered in future research 13‐14 …”

Section: Discussionsupporting

confidence: 63%

“…This study aimed to explore the decision‐making strategies of experienced radiographers in determining imaging and exposure factor selection in the context of obese patients. Currently, little is known about the individual cognitive steps taken in the decision‐making processes of radiographers when adapting technique for obese patients 11,14 . Breaking down intuitive decisions into individually explored thought processes could help facilitate the development of learning resources through the identification of key factors influencing the decisions radiographers make.…”

Section: Research Aimmentioning

confidence: 99%

“…There is no safe limit of ionising radiation dose, and thus, obtaining optimal diagnostic images at minimal dose should form the basis of all radiographic procedures 13‐14 . Adhering to this principle is particularly challenging in the context of obese imaging.…”

Section: Introductionmentioning

confidence: 99%

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Understanding radiographic decision‐making when imaging obese patients: A Think‐Aloud study

Seo

Robinson

Punch

et al. 2021

J of Medical Radiation Sci

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Introduction The incidence of obesity has been steadily rising over the last few decades and is having a significant impact upon the health system. In radiography, a particular challenge of imaging obese patients is implementing the as low as reasonably achievable (ALARA) principle when determining radiation dose, and technical and patient‐care adaptations. This study aimed to better understand the decision‐making strategies of experienced radiographers in determining imaging and exposure factor selection in the context of imaging obese patients. Methods This study employed a ‘think‐aloud,’ methodology, and eight experienced diagnostic radiographers working in clinical education were recruited to perform routine AP abdominal X‐ray projections on an anthropomorphic phantom. They were asked to simultaneously verbalise emerging thoughts as they considered positioning, exposure selection and image evaluation. This process was repeated with three different phantom sizes, each representing an increased BMI from ‘healthy,’ to, ‘morbidly obese.’ Audio recordings were transcribed and interpreted via Bowman’s (1997) theory of radiographic judgement and decision‐making. Results Analysis of interview transcripts identified 12 key concepts considered by experienced radiographers. Differences in radiographic concepts were considered when imaging phantoms of different sizes was demonstrated. A shift from segmental (e.g. positioning) to more environmental factors (e.g. patient comfort) and an increase in the number of verbal considerations with increasing phantom size were identified. The shift in focus of decision‐making stages identified the greater need to consider contextual factors such as patient comfort and repeatability when imaging obese patients. Conclusion Experienced radiographers find imaging obese patients challenging and alter their perception of image quality to accommodate for patient presentation. The findings will help inform future research, practice guidelines and learning resources to provide optimal imaging and care for obese patients, especially for student education.

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Section: Discussionsupporting

confidence: 63%

Section: Research Aimmentioning

confidence: 99%

See 1 more Smart Citation

Understanding radiographic decision‐making when imaging obese patients: A Think‐Aloud study

Seo

Robinson

Punch

et al. 2021

J of Medical Radiation Sci

View full text Add to dashboard Cite

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“…This unfortunately does not consider the potential variation amongst individual radiographers, a feature reported within previous radiographic studies. 27,28 Nevertheless, the findings of this study provide baseline data on imaging techniques used for neonatal imaging within incubators across Wales and the North-west of England. Furthermore, the study supports the need for standardisation and further optimisation work to ensure best practice for this vulnerable patient group.…”

Section: Discussionmentioning

confidence: 95%

Imaging neonates within an incubator – A survey to determine existing working practice

Tugwell-Allsup

England

2020

Radiography

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“…An application of exposure automation instead of manual settings has no effect on image quality, but its effect on the size of the received dose is proven [7,9,16,20]. Reference levels have been introduced for particular types of examination, that optimized the examination conditions as well as protecting the patient, taking into account the preparation and selection of the type of examination, the type of body part being examined, the thickness of the patient and kind of equipment used for imaging [21].…”

Section: Discussionmentioning

confidence: 99%

Physical parameters affecting the distribution of X-ray dose during hysterosalpingography

Kasprzyk,

Chmaj-Wierzchowska,

Jurczyk

2020

Clin. Exp. Obstet. Gynecol.

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Objective: Hysterosalpingography (HSG) is based on the administration of a shading agent to the uterine cavity and fallopian tubes using a Schulze apparatus. An X-ray beam (X) is then directed at the abdominal area of the patient and diagnostic images are obtained for evaluation. The radiation beam and its mode of administration have a decisive influence on the radiation dose to which the patient is exposed. The aim of this study was to determine the physical parameters of this exposure in such a way that the dose distribution during the HSG examination was the most beneficial for the patient. Materials and Methods: Measurements to evaluate the effect of exposure parameters on the quality of radiological images obtained during HSG in slim and obese patients were made in 216 repetitions of the standard HSG test. Additional research data was obtained from measurements made in the X-ray laboratory at the Clinical Hospital. Results: The comparison of all measurements made for experimental models simulating a slim and obese patient demonstrated that the dose distribution most advantageous for the patient is obtained for pulsations of an X-ray tube for PPS = 6, regardless of the thickness of the patient. Conclusions: The image quality and size of the radiation dose received during the HSG examination depends on the individual characteristics of the patient. During the measurements performed in order to compare the exposure conditions set by the automatic exposure control (AEC) system and the resulting dose, this study demonstrated that the dose distribution most advantageous for the patients is obtained for pulsations on an X-ray tube for PPS = 6, regardless of the thickness of the patient.

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Decision Making and Variation in Radiation Exposure Factor Selection by Radiologic Technologists

Cited by 5 publications

References 26 publications

Understanding radiographic decision‐making when imaging obese patients: A Think‐Aloud study

Understanding radiographic decision‐making when imaging obese patients: A Think‐Aloud study

Imaging neonates within an incubator – A survey to determine existing working practice

Physical parameters affecting the distribution of X-ray dose during hysterosalpingography

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