Dose tracking and rational examination selection for the medically-exposed population.

Tracking the radiation dose to medically-exposed populations can promote adoption of best practices among medical facilities that use ionizing radiation. Dose index registries provide an important tool for practices to benchmark their radiation doses for medical imaging and highlight areas where improvements may be made. However, individual patient dose tracking has many confounding variables to consider. It is not clear which dose measures should be tracked, and the variation among these dose measures must be understood relative to the variations in body habitus that are encountered in clinical practice. In addition, there are many uncertainties associated with risk estimation from low-dose radiation that relate to the age, gender, and life expectancy of the exposed individual. Other sources of variation in the use of ionizing radiation for medical imaging are of concern. Specifically, deviation from best practice in the use of medical imaging should be reduced, if not eliminated. Several tools exist to help reduce variation among practices when it comes to rational examination selection. Computerized order entry with decision support offers the promise to introduce these tools at the point of care, which should increase their use and adoption in the medical community at large.Introduction of Dose Tracking and Rational Exam Selection (Video 1:59, http://links.lww.com/HP/A33).