Justification of Imaging Medical Exposures: A Review of Literature to Guide Evidence-Based Practice in Zambia

Justification of Imaging Medical Exposures

Abstract

Background: The use of radiation in imaging has increased and resulted in major improvements in the diagnosis of diseases and injuries in medicine. Although the associated risks to patients exposed to radiation are low, the increase in demand is becoming a global concern due to unjustified imaging medical exposures.

 Objective: To review the literature on the causes of unnecessary medical exposures and strategies used to support referring medical practitioners in the justification of imaging examinations in order to guide evidence-based practice in Zambia.

 Methodology: Literature search was conducted in PubMed/MEDLINE database to find research, guidelines, expert opinions and reviews. This was supplemented by searching of radiology professional bodies and radiation protection websites. Nine publications were selected based on their relevance and included in this review.

 Results: Ten main causes of unjustified imaging medical exposures were identified: a lack of awareness about radiation doses and risks, a lack of referral guidelines, over-reliance on imaging, self-referral, defensive medicine, a lack of consultation, non-availability of non-ionising radiation modalities, requesting wrong investigations, repeating examinations which have already been performed, and failing to provide clinical information. Furthermore, three strategies to support medical practitioners were identified: education and training, referral guidelines, and clinical audits.

Conclusion: This review has highlighted the main causes of unjustified medical exposures and has brought about awareness of this subject. Even with the resource constraints, it is possible to adopt these strategies identified in this review to support medical practitioners in the justification of imaging medical exposures in Zambia.