TJC Calls for Restraint in Diagnostic Radiation

Cheryl Clark, for HealthLeaders Media , August 25, 2011

"Several recent studies have raised concerns about the risk of cancer from diagnostic imaging, especially in vulnerable populations such as children, young adults and pregnant women," the commission statement said.

Paul Schyve, MD, the commission's Senior Advisor for Healthcare Improvement, said in an interview Wednesday that the issue gained a higher profile because of a number of incidents that came to the Joint Commission's attention, some of which were widely reported by the media and some that were not.

"Over the past year or couple of years, the issue has been that people have started to identify that increasingly people are getting these diagnostic images using radiation, but almost nobody is keeping track of it, and all of a sudden, people are starting to see that this much use has side effects," he said.

"It was like 'To Err Is Human,' the report on medical errors by the Institute of Medicine in 1998. It wasn't that there was suddenly a dramatic increase in errors, but instead it rose to our attention that there's a risk here, a problem here, and we should be addressing this in the interests of patient safety."

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All of a sudden, it seemed, peoples' attention was focused on the issue, "and we at the Joint Commission said, you know, a lot more people are being subject to these risks because we're using these (tests more frequently. We better, all of us, pay attention to this."

Of course, a physician's clinical judgment is important, he emphasized. The radiologist or technician needs to use enough radiation to get an image that is appropriate to read that scan, but not too much, and not so little that the image has to be redone, requiring a second CT and more radiation.

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