{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:43:47Z","timestamp":1790167427139,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,7,23]],"date-time":"2018-07-23T00:00:00Z","timestamp":1532304000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Medical Radiation Sci"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The underpinning principles of radiation protection are justification, optimisation and limitation. Each medical imaging referral that uses ionising radiation must balance the justification of exposure to radiation against the benefits of the examination. Scrutiny of justification is the role of radiographers, for general radiography, and is usually performed using the clinical details provided on the referral. International studies report up to 77% of medical imaging examinations are unjustified or inappropriate. In regional Queensland, justification seems to involve a subjective assessment and enforcement is ad hoc. This study aimed to determine the number of unjustified emergency department x\u2010ray examinations performed in a regional Queensland hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An audit of the clinical details provided on x\u2010ray referrals and in the medical records was performed on x\u2010ray examinations undertaken within an 11\u2010day period. Justification was determined by compliance with the Government of Western Australia's diagnostic imaging pathways.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 186 referrals assessed, 75.3% were categorised as not having complied with the imaging pathway and were considered unjustified. When the clinical details in the patient's medical record were reviewed, in conjunction with the referral, the unjustified rate reduced to 49.2% of examinations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Results demonstrate a lack of information transfer by referring clinicians and a lack of compliance with justification requirements for imaging by medical imaging staff. Improved communication regarding the need for imaging, and the refusal of referrals that are not justified, will ensure that patients are only exposed to radiation when clear benefit has been demonstrated.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmrs.287","type":"journal-article","created":{"date-parts":[[2018,7,24]],"date-time":"2018-07-24T06:08:37Z","timestamp":1532412517000},"page":"184-191","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Prevalence of unjustified emergency department x\u2010ray examination referrals performed in a regional Queensland hospital: A pilot study"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6620-1257","authenticated-orcid":false,"given":"Marnie","family":"Rawle","sequence":"first","affiliation":[{"name":"Mackay Base Hospital Mackay Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4172-2056","authenticated-orcid":false,"given":"Alison","family":"Pighills","sequence":"additional","affiliation":[{"name":"Mackay Base Hospital Mackay Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,7,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/42893576"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0146645314551673"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.icrp.2008.07.001"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.icrp.2008.07.001"},{"key":"e_1_2_9_6_1","unstructured":"ARPANSA (Australian Radiation Protection and Nuclear Safety Agency).Code of practice for radiation protection in the medical applications of ionizing radiation radiation protection series no 14. Radiation Protection Series No 142008."},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1754-9485.2010.02173.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.12659\/PJR.896847"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-009-1640-y"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13244-013-0300-6"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzi078"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.05.0041"},{"key":"e_1_2_9_13_1","unstructured":"The Royal Australian and New Zealand College of Radiologists (RANZCR).Standards of practice for diagnostic and interventional radiology.2017. Report No: 10.2 (Accessed 23 January 2017) Available from:http:\/\/www.ranzcr.edu.au\/documents-download\/document-library-22\/document-library-25\/510-ranzcr-standards-of-practice-for-diagnostic-and-interventional-radiology."},{"key":"e_1_2_9_14_1","unstructured":"State of Queensland Parliamentary Counsel. Radiation Safety Act 1999 (Qld). Reprinted 2015. (Accessed 6 March 2018) Available from:https:\/\/www.legislation.qld.gov.au\/view\/whole\/pdf\/inforce\/current\/act-1999-020."},{"key":"e_1_2_9_15_1","unstructured":"State of Queensland Parliamentary Counsel. Radiation Safety Regulation 2010 (Qld). Reprinted 2017 (Accessed 6 March 2018) Available from:https:\/\/www.legislation.qld.gov.au\/view\/pdf\/inforce\/current\/sl-2010-0240."},{"key":"e_1_2_9_16_1","unstructured":"Medical Radiation Practice Board of Australia.Profesional capabilities for medical radiation practice. n.d. (Accessed 6 March 2018) Available from:http:\/\/www.medicalradiationpracticeboard.gov.au\/Registration\/Professional-Capabilities.aspx."},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzq016"},{"key":"e_1_2_9_18_1","unstructured":"Government of Western Australia. Diagnostic Imaging Pathways.2017(Accessed 5 October 2017) Available from:http:\/\/www.imagingpathways.health.wa.gov.au\/."},{"key":"e_1_2_9_19_1","unstructured":"GoergenS.Education modules for appropriate imaging referrals: clinical decision rules.2015. 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