Radiation exposure during imaging and shared decision making

描述（由申请人提供）：本申请的主要目的是为NIH-NHLBI赞助的题为“以患者为中心的成像-暴露于电离辐射的心脏成像程序的共享决策”的会议寻求资金，该会议将由美国核心脏病学会（ASNC）和心血管计算机断层扫描学会（SCCT）共同赞助。本次会议的目的是集中在临床导向的问题，在辐射暴露，将导致改善实验室的做法，为病人的安全。以前赞助的会议都集中在辐射生物学和流行病学证据联系辐射照射预测癌症风险，并缺乏实际适用性。本申请的目的是集中于用于改进关于辐射照射的医疗和患者教育的方法，并设计用于跟踪的容易适用的临床工具，以及设定包括最佳剂量减少策略的人群照射的质量度量。本次会议建议聚集临床CV成像专家，物理学家，以及医学和环境教育，医学伦理，和信息技术，以制定增强患者和医生对暴露于电离辐射的CV成像的理解的策略，并制定跟踪核心脏病学和CV计算机断层扫描（CT）成像程序的暴露和剂量降低的临床策略;最常用的无创CV成像程序使患者暴露于电离辐射。每年约有1170万患者接受CV CT和核心脏病学检查。 我们在本次会议中提出了三个主题，包括：主题#1，题为“以患者为中心的成像-暴露于电离辐射的CV成像程序的共同决策”。本主题拟讨论：a）旨在提高对成像和辐射暴露理解的新型教育工作，B）辐射风险患者知情同意的实施策略，以及c）提出与CV成像辐射相关的标准化报告。轨道#2题为辐射安全-质量指标。这条轨道建议：a）定义可可靠应用于CV成像的辐射暴露的可接受度量和实验室标准，以及B）实施辐射暴露的医疗保健系统跟踪。轨道#3题为国家标准剂量减少-持续质量倡议，认证和医疗保险决策。这条轨道建议审查现有的辐射剂量减少登记，并评估可行的地方，区域和全国范围内的扩展战略。 公共卫生相关性：我们提议召开一次会议，为医生和患者制定与使用特定心脏扫描相关的癌症风险的教育计划。本次会议将制定战略，帮助医生和患者了解辐射风险和心脏病检测的临床益处。此外，这次会议将制定战略，以跟踪平均患者暴露于辐射的实验室将适用于美国各地。

DESCRIPTION (provided by applicant): The primary aim of this application is to seek funding for an NIH-NHLBI-sponsored conference entitled "Patient-Centered Imaging-Shared Decision Making for Cardiac Imaging Procedures with Exposure to Ionizing Radiation" that will be co-sponsored by the American Society of Nuclear Cardiology (ASNC) and Society of Cardiovascular Computed Tomography (SCCT). The purpose of this conference is to focus on clinically- oriented issues in radiation exposure that will result in improved laboratory practices for patient safety. Previous sponsored conferences have focused on the radiation biology and epidemiologic evidence linking radiation exposure to projected cancer risk and have lacked practical applicability. The aim of the current application is to focus on methods for improved medical and patient education on radiation exposure and to devise readily applicable clinical tools for tracking, and set quality metrics for population exposure that include optimal dose reduction strategies. This conference proposes to assemble clinical CV imaging experts, physicists, and related scientists in the field of medical and environmental education, medical ethics, and information technology to devise strategies for enhanced patient and physician understanding of CV imaging with exposure to ionizing radiation and to devise clinical strategies for tracking exposure and dose reduction for both nuclear cardiology and CV computed tomographic (CT) imaging procedures; the most commonly applied noninvasive CV imaging procedures exposing patients to ionizing radiation. CV CT and nuclear cardiology procedures are performed in an estimated 11.7 million patients annually. We propose three tracks in this conference including: Track #1 entitled Patient-Centered Imaging - Shared Decision Making for CV Imaging Procedures with Exposure to Ionizing Radiation. This track proposes to discuss: a) novel educational efforts to improve comprehension of imaging and radiation exposure, b) implementation strategies for patient informed consent on radiation risk, and c) propose standardized reporting related to radiation for CV imaging. Track #2 entitled Radiation Safety - A Quality Metric. This track proposes to: a) define the accepted metric and laboratory standards for radiation exposure that may be reliably applied in CV imaging and b) implementation of healthcare system tracking of radiation exposure. Track #3 entitled National Standards for Dose Reduction - Continuous Quality Initiatives, Accreditation, and Healthcare Coverage Decisions. This track proposes to review existing radiation dose reduction registries and evaluate feasible local, regional, and nationwide expansion strategies. PUBLIC HEALTH RELEVANCE: We are proposing to do a conference to develop educational programs for doctors and patients on the risk of cancer associated with the use of specific heart scans. This conference will develop strategies to aid doctors and patients to understand radiation risk and the clinical benefit of heart disease detection. As well, this conference will develop strategies to track the average patient exposure to radiation for laboratories to be applied across the United States.