Letters
Medical practices
Volume 194 - Issue 3

Doctors’ knowledge of patient radiation exposure from diagnostic imaging requested in the emergency department

Authors:  Gerben B Keijzers and Charles J Britton

Med J Aust 2011; 194 (3): 151-152. || doi: 10.5694/j.1326-5377.2011.tb04206.x
Published online: 7 February 2011
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In reply: We thank Lavoipierre for his response to our article.1 He brings up two main points. First, he suggests that our statement that newer computed tomography (CT) scanners emit more radiation is incorrect.2 We acknowledge that actual absorbed doses for exactly the same imaging are lower with newer scanners, but the total exposure of the population may be increasing. In the United States, between 1993 and 2006, the annual number of CT scans increased by more than 10% per year, while the population increased less than 1% per year.3 If some scans are unnecessary for safe clinical care, then unsafe radiation exposure is a consequence.

His second point is that we should use common sense and not sensationalise our findings out of concern that some patients may not undergo scans that are clinically indicated. We are surprised by his interpretation of the risk of CT imaging, since we quoted a widely accepted estimate.4 Certainly, for an individual, the absolute risk increase is small and may be outweighed by the benefit the scan can provide. However, patients frequently undergo CT scans on the basis of a questionable clinical indication, or when safer imaging modalities would be superior. These unnecessary scans could be avoided. To that end, we advocate common sense, rational test ordering and appropriate discussion of risks, especially where the expected benefit of CT scanning is limited.

Authors

  • Gerben B Keijzers1
  • Charles J Britton1
  • 1. Gold Coast Hospital, Gold Coast, QLD.

Correspondence: gerben_keijzers@health.qld.gov.au

References

View this article on Wiley Online Library