TITLE:
Referring Physicians’ Knowledge on Justification of Medical Exposure in Diagnostic Imaging in a Sub-Saharan African Country, Cameroon
AUTHORS:
Boniface Moifo, Annick Laure Edzimbi, Haoua Tebere, Joshua Tambe, Richard Ndi Samba, Joseph Gonsu Fotsin
KEYWORDS:
Assessment; Justification; Referring Physician; Radiation Protection; Best Practices; Cameroon
JOURNAL NAME:
Open Journal of Radiology,
Vol.4 No.1,
February
20,
2014
ABSTRACT: Background: Justification is the process of weighing
the potential benefit of the exposure against potential detriment for that individual.
Its role has been largely delegated to imaging professionals. Nevertheless, justification
process involves referring physicians, radiographers and radiologists. Objective:
To assess the knowledge of referring physicians regarding justification of irradiating
examinations in medical imaging at the university-affiliated hospitals in Yaoundé
Cameroon. Materials and Methods: A questionnaire (18 questions) based on the French
guide for the proper use of medical imaging tests in relation to the justification
of irradiating examinations, was self-administered to 151 referring physicians in
Yaounde (Cameroon) between October 2012 and January 2013. The pre-tested questionnaire
was completed in the presence of the investigator. A scoring system was then adopted
with a total of 15 points from the level of knowledge on justification which could
be classified as satisfactory or not. Results: Referring physicians were 75 (49.7%)
GPs, 53 (35.1%) residents and 23 (15.2%) specialists. Knowledge on justification
was unsatisfactory for 79.5% of referring physicians with no significant difference
in terms of professional experience (p = 0.95) or specialty (p = 0.119). The concepts of “useful exam” and “justified exam” were not known by 113 (74.8%) and 95 (62.9%) practitioners.
MRI was selected as irradiating by 62 (41.1%), SPECT and PET-scan as non-radiating
examinations by 98 (64.9%) and 115 (76.1%) participants. The main reasons for repeating
a giving radiology exam were: unsatisfactory interpretation, unknown of where it
was performing and poor quality exam respectively for 23 (15.2%), 37 (24.5%)
and 43 (28.5%) referring physicians. Justification was the responsibility of the
referring physician alone for 57% of respondent. Only 11 clinicians knew the reference
of “Justification-Optimization-Limitation” to radiation protection. Conclusion: The knowledge
of physicians on radiating medical procedures and justification of requests for
these procedures is inadequate. Training in radiation protection and the introduction
of guidelines for the proper use of imaging tests could improve physicians’ justification
of radiating examinations.