Use of radiation for medical examinations and tests is the largest manmade source of radiation exposure, yet doctors are insufficiently aware of the long term health risks associated with radiological imaging, while long term risks are often ignored in cost effectiveness analysis of medical imaging.

According to the author, up to a third of radiological examinations are totally or partially inappropriate. To avoid this misuse, he believes that doctors should be required to have a radiological "driving licence" with penalty points given for inappropriate prescriptions.

Patients should be required to sign an explicit and transparent informed consent form for each radiological examination. This would help reduce pressure from patients for redundant examinations. Journals should also encourage reporting of radiation doses in papers.

The current culture has taught patients that the mot expensive tests are likely to be the most effective, says the author. In a culture of shared responsibility, any useless risk no matter how small should be avoided.

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Contact: Emma Dickinson
edickinson@bmj.com
44-207-383-6529
BMJ-British Medical Journal
4-Mar-2004