Shared Decision Making is a Key to Defining Radiation Risk

This post was authored by Leslee Shaw, MD, FACC, professor of medicine and co-director of the Emory Clinical Cardiovascular Research Institute at Emory University, and immediate past president of the American Society of Nuclear Cardiology.

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Over the last few years, we have seen more and more of a focus on patient-centeredness and the concept of shared decision making. This concept is never more important than it is when you are considering referral of a patient to a test that exposes them to ionizing radiation. The report, Developing an Action Plan for Patient Radiation Safety in Adult Cardiovascular Medicine from Pamela Douglas, MD, MACC and colleagues represents a seminal contribution to the field of cardiovascular medicine. Importantly, the action plan outlined in this document can help to create a safer laboratory testing environment for the millions of patients that undergo a cardiovascular procedure each year in the U.S.

But, as we move forward, in response to concerns over the growth in medical imaging and the ensuing dramatic growth in exposing large segments of the adult population to ionizing radiation, patient education is vital to better guide informed decision making with regards to cardiovascular procedure use. This concept puts the patient’s needs at the forefront of our concerns and not only for coronary artery disease detection and guided therapeutic management (i.e., benefits) but also any untoward consequences (i.e., risk – in this case, projected cancer risk of ionizing radiation exposure) of our commonly employed cardiovascular procedures.

Recently, ACC and the American Society of Nuclear Cardiology (ASNC) joined in a collaborative effort on ACC’s patient-centered website CardioSmart.org to add centralized information around imaging and radiation safety. The information will mirror the educational content on the importance of prevention and lifestyle modification, and will provide information on a variety of cardiovascular imaging modalities. In addition patients will receive educational content on understanding radiation exposure (and how it compares to environmental exposures including tsunamis as well as background exposure) as well as patient-centered approaches to risk-benefit decision making. This patient information will be available soon on CardioSmart.org.

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Please note that statements or opinions expressed herein reflect the views of the contributor, and do not reflect the official views of the ACCF, unless otherwise noted.

For more information about the Patient Radiation Safety Report visit CardioSource.


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