Response to letters regarding article, "Cumulative radiation exposure and cancer risk estimation in children with heart disease".
Response to letters regarding article, "Cumulative radiation exposure and cancer risk estimation in children with heart disease".
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对有关文章“心脏病儿童的累积辐射暴露和癌症风险评估”的信件的回复。
DOI：
10.1161/circulationaha.114.013266
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发表时间：
2015
期刊：
影响因子：
37.8
通讯作者：
Hill,KevinD
中科院分区：
文献类型：
--
作者：
Johnson,JasonN;Hornik,ChristophP;Li,JenniferS;BenjaminJr,DanielK;Yoshizumi,Terry;Reiman,RobertE;Frush,DonaldP;Hill,KevinD
我们感谢哈布伦、格拉茨等人和巴尔多的赞扬和批评。我们应用严格的分析方法来识别与电离辐射相关的风险，这对我们的患者非常重要。所有预测暴露后数十年发病率的队列研究都有局限性，我们的研究也不例外。在我们的文章中，我们强调了其中的许多限制。1我们同意Harbron的观点，即器官特异性癌症风险估计比有效剂量估计更可靠。我们使用有效剂量有几个原因：（1）虽然有效剂量不用于风险估计，但Smith-Bindman等人2证明了与器官特异性估计的合理相关性，并且在我们对导管插入器官剂量的初步评估中，我们得出了类似的结论;（2）我们没有评估的大多数成像模式的器官剂量，并选择使用跨模式的一致方法;和（3）尽管存在局限性，但有效剂量是比不考虑器官敏感性的剂量估计值（例如，空气比释动能、剂量面积乘积和剂量长度乘积）更好的量度。尽管如此，哈布伦提出的观点是突出的。正如我们在文章中所指出的，基于有效剂量的方法存在局限性。器官特异性估计将增加更大的准确性。
We thank Harbron, Glatz et al, and Bardo for their compliments and critiques. It is important for our patients that we apply rigorous methods of analysis to identify risks associated with ionizing radiation. All of the cohort studies that predict morbidity decades after exposure have limitations, and our study was no exception. In our article we highlighted many of these limitations. 1We agree with Harbron that organ-specific cancer risk estimates are more reliable than estimates derived from effective dose. We used effective dose for several reasons:(1) although effective dose is not intended for risk estimates, Smith-Bindman et al 2 demonstrated reasonable correlation with organ-specific estimates and, in our initial assessment of catheterization organ doses, we reached a similar conclusion;(2) we did not have organ doses for the majority of imaging modalities evaluated and chose to use a consistent methodology across modalities; and (3) despite limitations, effective dose is a better measure than dose estimates that do not account for organ sensitivity (eg, air kerma, dose area product, and dose length product). Nonetheless, the point made by Harbron is salient. As we noted in our article, there are limitations to an approach based on effective dose. Organ-specific estimates would add greater accuracy.
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影响因子：
5.1
作者：
Glatz, Andrew C.;Purrington, Kristen S.;Gruber, Peter J.
通讯作者：
Gruber, Peter J.
与普通计算机断层扫描检查相关的辐射剂量
DOI：
--
发表时间：
2017
期刊：
影响因子：
--
作者：
A. Mokhtar;Mohamed Mohamed Elawdy;Maysa Abd El;H. Refaie;T. El;Sabry A. El Mogy
通讯作者：
Sabry A. El Mogy
影响因子：
--
作者：
Smith-Bindman R;Lipson J;Marcus R;Kim KP;Mahesh M;Gould R;Berrington de González A;Miglioretti DL
通讯作者：
Miglioretti DL
影响因子：
1.6
作者：
Timotheus Watson;E. Mah;U. Joseph Schoepf;Lydia B. King;W. Huda;A. Hlavacek
通讯作者：
Timotheus Watson;E. Mah;U. Joseph Schoepf;Lydia B. King;W. Huda;A. Hlavacek