Overdiagnosis and overimaging: an ethical issue for radiological protection

Aims and objectives: This study aimed to analyse the key factors that influence the overimaging using X-ray such as self-referral, defensive medicine and duplicate imaging studies and to emphasize the ethical problem that derives from it. Materials and methods: In this study, we focused on the more frequent sources of overdiagnosis such as the total-body CT, proposed in the form of screening in both public and private sector, the choice of the most sensitive test for each pathology such as pulmonary embolism, ultrasound investigations mostly of the thyroid and of the prostate and MR examinations, especially of the musculoskeletal system. Results: The direct follow of overdiagnosis and overimaging is the increase in the risk of contrast media infusion, radiant damage, and costs in the worldwide healthcare system. The theme of the costs of overdiagnosis is strongly related to inappropriate or poorly appropriate imaging examination. Conclusions: We underline the ethical imperatives of trust and right conduct, because the major ethical problems in radiology emerge in the justification of medical exposures of patients in the practice. A close cooperation and collaboration across all the physicians responsible for patient care in requiring imaging examination is also important, balancing possible ionizing radiation disadvantages and patient benefits in terms of care

FMECA Application in Tomotherapy: Comparison between Classic and Fuzzy Methodologies

Accident analysis in radiotherapy highlighted the need to increase quality assurance (QA) programs by the identification of failures/errors with very low probability (rare event) but very severe consequences. In this field, a Failure Mode, Effects and Criticality Analysis (FMECA) technique, used in various industrial processes to rank critical events, has been met with much interest. The literature describes different FMECA methods; however, it is necessary to understand if these tools are incisive and effective in the healthcare sector. In this work, comparisons of FMECA methodologies in the risk assessment of patients undergoing treatments performed with helical tomotherapy are reported. Failure modes identified for the phases "treatment planning" and "treatment execution" are classified using the Risk Priority Number (RPN) index. Differences and similarities in the classification of failures/errors of the examined FMECA approaches are highlighted

Report of IRPA task group on the impact of the eye lens dose limits

In 2012 IRPA established a task group (TG) to identify key issues in the implementation of the revised eye lens dose limit. The TG reported its conclusions in 2013. In January 2015, IRPA asked the TG to review progress with the implementation of the recommendations from the early report and to collate current practitioner experience. This report presents the results of a survey on the view of the IRPA professionals on the new limit to the lens of the eye and on the wider issue of tissue reactions. Recommendations derived from the survey are presented. This report was approved by IRPA Executive Council on 31 January 2017

Dichiarazione ICRP sulle reazioni tissutali ed effetti immediati e tardivi delle radiazioni nei tessuti e negli organi normali - Dosi soglia per le reazioni tissutali nell’ambito della radioprotezione

La pubblicazione ICRP 118 riesamina gli effetti precoci e tardivi delle radiazioni ionizzanti nei diversi organi ed apparati e fornisce stime aggiornate sulle dosi soglia per l'induzione delle numerose reazioni tissutali analizzate. In particolare, a seguito dei progressi nelle conoscenze radiobiologiche e cliniche, pubblicati in numerosi testi specialistici, vengono dettagliatamente presentate le evidenze che hanno condotto alle modificazioni, rispetto alle Raccomandazioni ICRP 103/2007, nella individuazione delle dosi soglia per la induzione della cataratta e delle patologie del sistema circolatorio da parte delle radiazioni ionizzanti. A queste rilevanti considerazioni si affiancano gli approfonditi aggiornamenti sulle conoscenze radiobiologiche e cliniche e le integrazioni delle dosi soglia, individuate in modo più articolato rispetto alle precedenti pubblicazioni, per tutte le altre reazioni tissutali, che rendono questo documento un indispensabile strumento di lavoro e di analisi per tutti coloro che si occupano di radioprotezione, con particolare riferimento agli specialisti di radioprotezione medica. La traduzione in italiano dell’intero testo vuole facilitare la diffusione delle peculiari informazioni contenute nella pubblicazione e motivare una sempre più approfondita ricerca in questo settore che indubbiamente contribuisce a ridurre i rischi derivanti dall’esposizione alle radiazioni ionizzanti. La realizzazione della versione italiana di questa pubblicazione ha richiesto un notevole impegno qualitativo e quantitativo ed è stata possibile per il considerevole e qualificante contributo dei medici dell’AIRM e dei membri del Comitato Internazionale dell'AIRP. A tutti coloro che hanno collaborato alla sua traduzione, revisione e pubblicazione con notevole spirito di sacrificio, è rivolto l'apprezzamento e la riconoscenza delle nostre Associazioni, che riuniscono gli operatori attivi nei vari settori di interesse della radioprotezione

Towards a strategic research agenda for social sciences and humanities in radiological protection

Reflecting a change in funding strategies for European research projects, and a commitment to the idea of responsible research and innovation in radiological protection (RP), a collective of research institutes and universities have developed a prospective Strategic Research Agenda (SRA) for Social Sciences and Humanities (SSH) in radiological protection. This is the first time such a research agenda has been proposed. This paper identifies six research lines of interest and concern: 1) Effects of social, psychological and economic aspects on RP behaviour; 2) Holistic approaches to the governance of radiological risks; 3) Responsible research and innovation in RP; 4) Stakeholder engagement and participatory processes in RP research, development, policy and practice; 5) Risk communication; and 6) RP cultures. These topics were developed through broad stakeholder consultation, in conjunction with activities carried out in the framework of various projects and initiatives (EU H2020 CONCERT programme, the EU FP7 projects OPERRA, PREPARE and EAGLE, the 2015-2018 RICOMET series of conferences, and the 2014 and 2016 International Symposia on Ethics of Environmental Health); as well as through dialogues with members of the European radiation protection research communities. The six research lines open opportunities to integrate a range of key social and ethical considerations into RP, thereby expanding research opportunities and programmes and fostering collaborative approaches to research and innovation

Towards a strategic research agenda for social sciences and humanities in radiological protection

peer reviewedReflecting a change in funding strategies for European research projects, and a commitment to the idea of responsible research and innovation in radiological protection (RP), a collective of research institutes and universities have developed a prospective Strategic Research Agenda (SRA) for Social Sciences and Humanities (SSH) in radiological protection. This is the first time such a research agenda has been proposed. This paper identifies six research lines of interest and concern: 1) Effects of social, psychological and economic aspects on RP behaviour; 2) Holistic approaches to the governance of radiological risks; 3) Responsible research and innovation in RP; 4) Stakeholder engagement and participatory processes in RP research, development, policy and practice; 5) Risk communication; and 6) RP cultures. These topics were developed through broad stakeholder consultation, in conjunction with activities carried out in the framework of various projects and initiatives (EU H2020 CONCERT programme, the EU FP7 projects OPERRA, PREPARE and EAGLE, the 2015-2018 RICOMET series of conferences, and the 2014 and 2016 International Symposia on Ethics of Environmental Health); as well as through dialogues with members of the European radiation protection research communities. The six research lines open opportunities to integrate a range of key social and ethical considerations into RP, thereby expanding research opportunities and programmes and fostering collaborative approaches to research and innovation

Revised Strategic Research Agenda for Social Sciences and Humanities in Radiation Protection

This document describes the research priorities and the Strategic Research Agenda (SRA) for Social Sciences and Humanities (SSH) in radiation protection for the next 20 years. It also reports on the results of a first gap analysis. The SSH SRA is a living document, under constant development through the engagement of the SSH community in radiation protection field and other stakeholders, especially technical and research platforms. To this end, the SSH community in radiation protection field will structure and enhance dialogue at the European level among the different stakeholders, fostering the sharing of knowledge and information among various disciplines working on aspects of radiation protection and identify the SSH research needs in the field of radiation protection. The objective of Strategic Research Agenda (SRA) for Social Sciences and Humanities (SSH) in radiation protection is to contribute towards improvement of the Radiation Protection (RP) system by coordinating European SSH research in the field of radiation protection; supporting education and training; knowledge management and sharing; and identifying SSH state of the art across domains. It is only by enabling SSH research to play a fuller and stronger role through a coordinated SRA mechanism that societal perspectives on research relating to radiation protection will be realised. The SSH SRA has been developed through a broad stakeholder engagement process. The research topics to be included in the SSH SRA have been collected through various activities carried out in the H2020 projects CONCERT and the FP7 projects OPERRA, PREPARE and EAGLE, notably the RICOMET 2015, 2016 an RICOMET 2017 conferences and Symposium on Ethics of Environmental Health, as well as in dialogues with members of the radiation protection platforms, carried out in a context of the CONCERT 2.6 task group. These research topics have been prioritised for the first time at the Radiation Protection Week in Oxford (19-23 September 2016) with task 2.6 members, SSH community and platforms, and further debated upon at the RICOMET Conference 2017 (June 27th to 29th, Vienna) with a large audience. The version summarised in this report is the most recent revision on of the SSH SRA (D2.8 and D2.10)

Corresponding member di The "Coordination Action" CONRAD : a Coordinated Network for Radiation Dosimetry

The objectives of this action are the analysis of the options for sustainable networks linking research actors and end users, and to coordinate research into measurements and calculations for radiation protection at workplaces. The "Coordination Action" CONRAD (A Coordinated Network for Radiation Dosimetry) was sponsored by the EC within its 6th Framework Programme