title: The effect of fellows' training in invasive cardiology on radiological exposure of patients.
abstract: The aim of this work was to evaluate and quantify the impact of an invasive training of cardiology fellows on some exposure parameters. From 1 January 2000 to 31 December 2002, three staff members performed 2.582 diagnostic procedures (Group 1) that were compared with 819 performed by, or with the participation of five cardiology fellows (Group 2). Exposure parameters were as follows (Group 1/Group 2): fluoroscopy time 3.8 +/- 4.5/5.5 +/- 5.9 min (+38%), mean number of frames 589 +/- 282/642 +/- 260 (+9%), Kerma-area product (KAP) during fluoroscopy 10.6 +/- 14/15.5 +/- 16 Gycm2 (+45%), KAP during cine-angiography 20.8 +/- 14/22.5 +/- 12 (+8%), total KAP 31.5 +/- 28/38.1 +/- 28 (+21%). Differences were all significant (P <or= 0.001 for all comparisons). For individual fellows, a trend towards reduction of exposure parameters was seen over time, but only KAP(cine) was significant (25.7 +/- 14/22.2 +/- 11 Gycm2, P <or= 0.001). In conclusion, all parameters measured in this study increased significantly in diagnostic procedures performed with fellows when compared with staff members alone, fluoroscopy time and the related KAP in particular. Careful supervision limited these increases so that exposures remained within acceptable limits.
authors.affiliation: SOC di Cardiologia, Azienda Ospedaliero-Universitaria S Maria della Misericordia, Udine, Italy. bernardi.guglielmo@aoud.sanita.fvg.it
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Bernardi
authors.forename: Renato
authors.initials: R
authors.lastname: Padovani
authors.forename: Annalisa
authors.initials: A
authors.lastname: Trianni
authors.forename: Giorgio
authors.initials: G
authors.lastname: Morocutti
authors.forename: Leonardo
authors.initials: L
authors.lastname: Spedicato
authors.forename: Davide
authors.initials: D
authors.lastname: Zanuttini
authors.forename: Marika
authors.initials: M
authors.lastname: Werren
authors.forename: Louis K
authors.initials: LK
authors.lastname: Wagner
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D002309:Cardiology / Q000193:education*; D016009:Chi-Square Distribution; D002983:Clinical Competence; D003287:Contrast Media; D017023:Coronary Angiography; D005257:Fellowships and Scholarships; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011829:Radiation Dosage; D011871:Radiology / Q000193:education*
chemical_list: D003287:Contrast Media