radiological exposure evaluation through the computerised electronic records system as decisional support to x-ray examination justification in family medicine

Background In recent decades, patients' exposure to ionising radiation (IR) during diagnostic examinations has increased a great deal. X-ray requests do not always conform to the principle of 'justification', which emphasises the real utility and necessity of the examination. Databases maintained by general practitioners usually record all requests for radiological examinations of their patients and could be configured to assess the radiological risk for each patient. Objective To show, through the analysis of the data extracted from a database commonly used by Italian general practitioners, whether it is possible to measure patients' exposure to IR in the previous five years, so that doctors are aware of thiswhen they refer patients for examination involving further exposure to radiation. Method Records of 120 patients from an Italian general practice were randomly extracted from the practice database. The patients were a mix of male and female, aged from 15 to 64 years. All radiological examinations performed in the previous five years were recorded in a special spreadsheet, which had been created for computing the exposure to ionising radiation in milliSiviert. Results The calculated cumulative exposure of the 120 patients showed a very different perspective, which could help doctors when applying the principle of justification and allow accurate information to be communicated to the patient concerning their relevant health problem. Conclusions Databases maintained by general practitioners could easily be configured to automatically compute the radiological risk for each patient and to alert the doctor when an X-ray examination is prescribed, giving the doctor crucial decisional support for its justification.