Radiographers’ Perspectives on Justification of Radiographic Procedure in Klang Valley
DOI:
https://doi.org/10.21834/e-bpj.v11i35.7663Keywords:
Justification, Radiographer, Medical ImagingAbstract
Justification ensures that radiological examinations are clinically warranted and that benefits outweigh radiation risks and costs. This qualitative exploratory study examined how radiographers in private hospitals in the Klang Valley perceive and enact justification in practice. Semi-structured interviews were conducted with ten purposively selected radiographers and analysed thematically. Participants routinely checked clinical information, correlated indications with requested examinations and consulted referrers when doubt arose, but reported limited authority, inadequate referral details and workflow constraints. Strengthening policies, communication and digital referral systems could support safer, more patient-centred imaging.
References
Alele, F., & Malau-Aduli, B. (2023, February 22). 4.3 qualitative research methodologies. Pressbooks. https://jcu.pressbooks.pub/intro-res-methods-health/chapter/4-3-qualitativeresearch-methodologies/
Atabo, S. M., & Umar, A. A. (2019). A review of imaging techniques in scientific research/clinical diagnosis. MOJ Anatomy & Physiology,
(5). https://doi.org/10.15406/mojap.2019.06.00269 DOI: https://doi.org/10.15406/mojap.2019.06.00269
Braun, V., & Clarke, V. (2021). Thematic analysis: A practical guide. SAGE Publications.
Chilanga, C. C., Olerud, H. M., & Lysdahl, K. B. (2022). Radiographers’ actions and challenges when confronted with inappropriate radiology referrals. European Radiology, 32(6), 4210–4217. https://doi.org/10.1007/s00330-021-08470-z DOI: https://doi.org/10.1007/s00330-021-08470-z
Chilanga, C. C., & Lysdahl, K. B. (2024). The radiographers’ opinion on assessing radiological referrals. Radiography, 30(2), 605–
https://doi.org/10.1016/j.radi.2024.01.016 DOI: https://doi.org/10.1016/j.radi.2024.01.016
Clarke, J., Akudjedu, T., & Salifu, Y. (2023). Vetting of medical imaging referrals: A scoping review of the radiographers’ role. Radiography, 29(4), 767–776. https://doi.org/10.1016/j.radi.2023.05.008 DOI: https://doi.org/10.1016/j.radi.2023.05.008
Del Llano, M. P., Teresa, F. M., & Santos, Á. M. (2023). Royal Decree 601/2019 on justification and optimization: Practical aspects. Radiología (English Edition), 65(4), 338–351. https://doi.org/10.1016/j.rxeng.2022.12.004 DOI: https://doi.org/10.1016/j.rxeng.2022.12.004
Foley, S. J., Bly, R., Brady, A. P., Ebdon-Jackson, S., Karoussou-Schreiner, A., Hierath, M., Sosna, J., & Brkljačić, B. (2022). Justification of CT practices across Europe: Results of a survey of national competent authorities and radiology societies. Insights into Imaging, 13(1). https://doi.org/10.1186/s13244-022-01325-1 DOI: https://doi.org/10.1186/s13244-022-01325-1
Goldberg, J., McClaine, R. J., Cook, B., Garcia, V. F., Brown, R. L., Crone, K., & Falcone, R. A. (2011). Use of a mild traumatic brain injury guideline to reduce inpatient hospital imaging and charges. Journal of Pediatric Surgery, 46(9), 1777–1783. https://doi.org/10.1016/j.jpedsurg.2011.02.052 DOI: https://doi.org/10.1016/j.jpedsurg.2011.02.052
Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods, 18(1), 59–82. https://doi.org/10.1177/1525822X05279903 DOI: https://doi.org/10.1177/1525822X05279903
Hussain, S., Mubeen, I., Ullah, N., Shah, S. S. U. D., Khan, B. A., Zahoor, M., Ullah, R., Khan, F. A., & Sultan, M. A. (2022). Modern diagnostic imaging techniqueapplications and risk factors in the medical field: A review. BioMed Research International, 2022, 1–19. https://doi.org/10.1155/2022/5164970 DOI: https://doi.org/10.1155/2022/5164970
International Atomic Energy Agency. (2024). Justification and optimization in medical imaging. https://www.iaea.org/resources/rpop/resources/international-safetystandards/justification-and-optimization
Khan, S. N. (2014). Qualitative research method–phenomenology. Asian Social Science, 10(21), 298. DOI: https://doi.org/10.5539/ass.v10n21p298
Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Sage. DOI: https://doi.org/10.1016/0147-1767(85)90062-8
Mork-Knudsen, H., Lysdahl, K., & Chilanga, C. (2021). Workplace factors facilitating the radiographers’ assessment of referrals for diagnostic imaging: A qualitative study. Radiography, 28(1), 24–30. https://doi.org/10.1016/j.radi.2021.07.013 DOI: https://doi.org/10.1016/j.radi.2021.07.013
Pearce, M. S., Salotti, J. A., Little, M. P., McHugh, K., Lee, C., Kim, K. P., Howe, N. L., Ronckers, C. M., Rajaraman, P., Craft, A. W., Parker, L., & De González, A. B. (2012). Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: A retrospective cohort study. The Lancet, 380(9840), 499–505. https://doi.org/10.1016/S0140-6736(12)60815-0 DOI: https://doi.org/10.1016/S0140-6736(12)60815-0
Rawle, M., & Pighills, A. (2018). Prevalence of unjustified emergency department X-ray examination referrals performed in a regional Queensland hospital: A pilot study. Journal of Medical Radiation Sciences, 65(3), 184–191. https://doi.org/10.1002/jmrs.287 DOI: https://doi.org/10.1002/jmrs.287
Reitan, A. F., Sanderud, A., & Mussmann, B. R. (2024). Radiographers’ role in justification of medical imaging examinations. Journal of Medical Imaging and Radiation Sciences, 55(1), 74–81. https://doi.org/10.1016/j.jmir.2023.12.007 DOI: https://doi.org/10.1016/j.jmir.2023.12.007
Sharma, N. K., Sharma, R., Mathur, D., Sharad, S., Minhas, G., Bhatia, K., Anand, A., & Ghosh, S. P. (2018). Role of ionizing radiation in neurodegenerative diseases. Frontiers in Aging Neuroscience, 10. https://doi.org/10.3389/fnagi.2018.00134 DOI: https://doi.org/10.3389/fnagi.2018.00134
Sitareni, M., Karera, A., Amkongo, M., & Daniels, E. (2023). Justification of radiological procedures: Radiographers’ experiences at two public hospitals. Journal of Medical Imaging and Radiation Sciences, 54(2), 312–318. https://doi.org/10.1016/j.jmir.2023.02.011 DOI: https://doi.org/10.1016/j.jmir.2023.02.011
Suruhanjaya Perkhidmatan Awam Malaysia – Juru X-Ray Gred U29. (2024). SPA. Retrieved October 13, 2024, from https://www.spa.gov.my/spa/laman-utama/gaji-syarat-lantikan-deskripsi-tugas/diploma-stpm-stam-hsc/juru-x-ray-u29
Valentin, J. (Ed.). (2008). ICRP Publication 105: Radiological protection in medicine. SAGE Publications.
Vom, J., & Williams, I. (2017). Justification of radiographic examinations: What are the key issues? Journal of Medical Radiation Sciences, 64(3), 212–219. DOI: https://doi.org/10.1002/jmrs.211
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