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Are Restrictive Medical Radiation Imaging Campaigns Misguided? It Seems So: A Case Example of the American Chiropractic Association's Adoption of "Choosing Wisely".
Dose-Response ( IF 2.5 ) Pub Date : 2020-05-01 , DOI: 10.1177/1559325820919321
Paul A Oakley 1 , Deed E Harrison 2
Affiliation  

Since the 1980s, increased utilization of medical radiology, primarily computed tomography, has doubled medically sourced radiation exposures. Ensuing fear-mongering media headlines of iatrogenic cancers from these essential medical diagnostic tools has led the public and medical professionals alike to display escalating radiophobia. Problematically, several campaigns including Image Gently, Image Wisely, and facets of Choosing Wisely propagate fears of all medical radiation, which is necessary for the delivery of effective and efficient health care. Since there are no sound data supporting the alleged risks from low-dose radiation and since there is abundant evidence of health benefits from low-doses, these imaging campaigns seem misguided. Further, thresholds for cancer are 100 to 1000-fold greater than X-rays, which are within the realm of natural background radiation where no harm has ever been validated. Here, we focus on radiographic imaging for use in spinal rehabilitation by manual therapists, chiropractors, and physiotherapists as spinal X-rays represent the lowest levels of radiation imaging and are critical in the diagnosis and management of spine-related disorders. Using a case example of a chiropractic association adopting "Choosing Wisely," we argue that these campaigns only fuel the pervasive radiophobia and continue to constrain medical professionals, attempting to deliver quality care to patients.

中文翻译:

限制性医学放射成像运动被误导了吗?它看起来如此:美国脊骨治疗学会采用“明智选择”的一个案例。

自1980年代以来,对医学放射学(主要是计算机断层摄影)的利用增加,使医学放射源的暴露量翻了一番。这些必不可少的医学诊断工具引起了越来越多的引起医源性恐惧的媒体头条,导致公众和医学专业人士都表现出日益严重的恐惧症。有问题的是,包括“轻轻地进行图像”,“明智地进行图像处理”以及“明智地进行选择”方面的数项运动传播了人们对所有医疗辐射的恐惧,而这对于提供有效而有效的医疗保健是必不可少的。由于没有声音数据支持低剂量辐射的所谓风险,并且有大量证据表明低剂量辐射对健康有好处,因此这些成像运动似乎是被误导的。此外,癌症的阈值比X射线高100到1000倍,在自然背景辐射的范围内,没有任何危害得到证实。在这里,我们重点介绍由手动治疗师,脊医和物理治疗师在脊柱康复中使用的放射成像,因为脊柱X射线代表最低水平的放射成像,对脊柱相关疾病的诊断和管理至关重要。我们以整脊协会采用“明智地选择”为例,我们认为这些运动只会助长普遍的放射恐惧症,并继续限制医疗专业人员,试图为患者提供优质的护理。脊柱X射线和物理治疗师代表着最低水平的放射成像,对脊柱相关疾病的诊断和管理至关重要。我们以整脊协会采用“明智地选择”为例,我们认为这些运动只会助长普遍的放射恐惧症,并继续限制医疗专业人员,试图为患者提供优质的护理。脊柱X射线和物理治疗师代表着最低水平的放射成像,对脊柱相关疾病的诊断和管理至关重要。我们以整脊协会采用“明智地选择”为例,我们认为这些运动只会助长普遍的放射恐惧症,并继续限制医疗专业人员,试图为患者提供优质的护理。
更新日期:2020-05-01
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