2019 AAPM Annual Meeting
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Session Title: Communicating Benefit to Risk Ratio from Radiology Exams to the Patient and Provider
Question 1: The risks of low doses of ionizing radiation …
Reference:Brenner DJ, Doll R, Goodhead DT, Hall EJ, Land CE, Little JB, Lubin JH, Preston DL, Preston RJ, Puskin JS, Ron E, Sachs RK, Samet JM, Setlow RB, Zaider M. Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proc Natl Acad Sci U S A. 2003 Nov 25;100(24):13761-6. Epub 2003 Nov 10. National Research Council (1995) Radiation Dose Reconstruction for Epidemiologic Uses (Natl. Acad. Press, Washington, DC).
Choice A:are well understood from atomic bomb survivor studies
Choice B:can be extrapolated from high dose studies
Choice C:are unknown, due to need to study large populations over many years
Choice D:are supported by data from the 2012 UNSCEAR report
Question 2: The BEIR VII report derives its risk estimates from:
Reference:Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation. National Research Council. Health Risks from Exposure to low levels of Ionizing Radiation: BEIR VII – Phase 2. Washington DC, National Academies Press 2006.
Choice A:Environmental and occupational radiation studies
Choice B:Medical radiation and atomic bomb survivor studies
Choice C:Medical and occupational radiation studies
Choice D:Only atomic bomb survivor studies
Question 3: To communicate effectively with a patient or patient’s representative, a health professional must:
Reference:Sinclair et.al. Sympathy, empathy, and compassion: A grounded theory study of palliative care patients’ understandings, experiences, and preferences, Palliat Med. 2017 May; 31(5): 437–447.
Choice A:understand their level of understanding of the science
Choice B:understand their concerns
Choice C:understand the information they already “know” whether correct or incorrect
Choice D:understand all of the above
Question 4: Patients or patient’s representatives may be alerted to the possibility of skin effects for skin doses exceeding:
Reference:International Council on Radiation Protection and Measurement, Report # 103, Vol 378 (2-4), 2007. Wagner LK, Eifel PJ, Geise RA, Potential biological effects following high x-ray dose interventional procedures. J Vasc Interven Radiol 5:71,1994.
Choice A:3 mSv
Choice B:30 mSv
Choice C:300 mSv
Choice D:3000 mSv
Question 5: There is some epidemiological evidence of increased cancer incidence later in life following exposure to levels of ionizing radiation encountered in which pediatric exams?
Reference:Linet MS, Kim KP, Rajaraman P. Children's exposure to diagnostic medical radiation and cancer risk: epidemiologic and dosimetric considerations. Pediatric Radiology 2009; 39 Suppl 1: S4-S26.
Choice A:chest radiographs
Choice B:repeated CT scans
Choice C:MRI
Choice D:Ultrasound
Question 6: Feelings of helplessness and concern parents have for their child may come across as agitation or aggression. What is a common technique to help diffuse the parent’s agitation?
Reference:Lofchy J, and Fage B; Practical Tips for Managing the Agitated Patient: Avoiding Violence in the Clinical Setting, Psychiatric Times Feb 28, 2017 34(2)
Choice A:Help the parent understand the need for the examination
Choice B:Tell them we cannot proceed until they calm down
Choice C:Help the parent to feel in control of the situation
Choice D:Tell them you are the expert and they should trust you
Question 7: When surveyed, why are parents of chronically ill patients found to be most frustrated when visiting large multi-location radiology clinics?
Reference:Irving AV Policies and procedures for health care organizations: a risk management perspective; PSQH Oct 13 2014.
Choice A:They feel marginalized when sent to outpatient centers instead of the main hospital campus
Choice B:They are required to travel to different sites to receive patient care
Choice C:They feel their standard of care is lower at outpatient centers
Choice D:They are confused by inconsistent practices/policies between the main hospital campus and satellite clinics
Question 8: A common communication technique employed to address a concerned parent’s question(s) is to:
Reference:Mind Tools Content Team, Questioning Techniques, asking questions effectively; www.mindtools.com/pages/article/newTMC_88.htm (accessed 4/25/19 online)
Choice A:Use scientific jargon to ease their concern and come across as competent
Choice B:Respond by echoing their concern as a question to better understand the root of their concern
Choice C:Tell them whatever they want to hear to calm them down, and then get the examination over as soon as possible.
Choice D:Respond by telling them all will be well and they shouldn’t worry about anything; they are in good hands!
Question 9: Useful techniques during a parental discussion on radiation risks include all of the following except;
Reference:Kasraie, N., Jordan, D., Keup, C., & Westra, S. (2018). Optimizing Communication With Parents on Benefits and Radiation Risks in Pediatric Imaging. Journal of the American College of Radiology : JACR, 15(5), 809�817. http://doi.org/10.1016/j.jacr.2018.0
Choice A:Listening carefully and acknowledging a parent or child’s concerns about radiation.
Choice B:Framing the risk of medical radiation in comparison to other more commonly understood risks.
Choice C:Addressing the clinical appropriateness of the examination.
Choice D:Reassurance that the risks of medical radiation have never been conclusively proven and thus their concerns are unwarranted.
Question 10: Which of the following assumptions about parental preferences relating to medical radiation are incorrect?
Reference:Broder, J. S., & Frush, D. P. (2014). Content and style of radiation risk communication for pediatric patients. Journal of the American College of Radiology : JACR, 11(3), 238�242. http://doi.org/10.1016/j.jacr.2013.10.003 Guillerman, R. P. (2014). Fr
Choice A:Contextualizing the need for the examination through discussion with their child’s pediatrician.
Choice B:Personalized estimate of additional lifetime cancer risk.
Choice C:Discussion of alternative imaging methods only confuses parents and should be avoided.
Choice D:Most parents are satisfied with the level of discussion provided on radiation risks when their child is ill.
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