PubMed · 15742527
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2005. Sacral nerve stimulation for urinary control.. https://pubmed.ncbi.nlm.nih.gov/15742527/
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This study investigated the variability in baseline computed tomography colonography (CTC) performance using untrained readers by documenting sources of error to guide future training requirements. Twenty CTC endoscopically validated data sets containing 32 polyps were consensus read by three unblinded radiologists experienced in CTC, creating a reference standard. Six readers without prior CTC training [four residents and two board-certified subspecialty gastrointestinal (GI) radiologists] read the 20 cases. Readers drew a region of interest (ROI) around every area they considered a potential colonic lesion, even if subsequently dismissed, before creating a final report. Using this final report, reader ROIs were classified as true positive detections, true negatives correctly dismissed, true detections incorrectly dismissed (i.e., classification error), or perceptual errors. Detection of polyps 1-5 mm, 6-9 mm, and > or =10 mm ranged from 7.1% to 28.6%, 16.7% to 41.7%, and 16.7% to 83.3%, respectively. There was no significant difference between polyp detection or false positives for the GI radiologists compared with residents (p=0.67, p=0.4 respectively). Most missed polyps were due to failure of detection rather than characterization (range 82-95%). Untrained reader performance is variable but generally poor. Most missed polyps are due perceptual error rather than characterization, suggesting basic training should focus heavily on lesion detection.
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BACKGROUND: There is increasing awareness among pediatric radiologists of the potential risks associated with ionizing radiation in medical imaging. However, it is not known whether there has been a corresponding increase in awareness among pediatricians. OBJECTIVE: To establish the level of awareness among pediatricians of the recent publicity on radiation risks in children, knowledge of the relative doses of radiological investigations, current practice regarding parent/patient discussions, and the sources of educational input. MATERIALS AND METHODS: Multiple-choice survey. RESULTS: Of 220 respondents, 105 (48%) were aware of the 2001 American Journal of Roentgenology articles on pediatric CT and radiation, though only 6% were correct in their estimate of the quoted lifetime excess cancer risk associated with radiation doses equivalent to pediatric CT. A sustained or transient increase in parent questioning regarding radiation doses had been noticed by 31%. When estimating the effective doses of various pediatric radiological investigations in chest radiograph (CXR) equivalents, 87% of all responses (and 94% of CT estimates) were underestimates. Only 15% of respondents were familiar with the ALARA principle. Only 14% of pediatricians recalled any relevant formal teaching during their specialty training. The survey response rate was 40%. CONCLUSION: Awareness of radiation protection issues among pediatricians is generally low, with widespread underestimation of relative doses and risks.