|Year : 2021 | Volume
| Issue : 1 | Page : 42-45
Assessment of awareness of ultrasound safety among ultrasound users in King Saudi Arabia
Mohamed Adam1, Moawia Gameraddin2, Magbool Alelyani1, Abdullah Laghbi1, Ibtisam Abdallah3, Nada A Alqahtani1
1 Department of Diagnostic Radiology, Faculty of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
2 Department of Diagnostic Radiologic Technology, Faculty of Applied Medical Sciences, Taibah University, Al-Madinah, Saudi Arabia
3 Department of Radiology, College of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia
|Date of Submission||30-Dec-2020|
|Date of Decision||15-Feb-2021|
|Date of Acceptance||03-Mar-2021|
|Date of Web Publication||31-Jul-2021|
Department of Diagnostic Radiology, Faculty of Applied Medical Sciences, King Khalid University, Abha
Source of Support: None, Conflict of Interest: None
Background: Ultrasound (US) is an imaging method with significant diagnostic value; it is one of the most important diagnostic tools used by a wide range of health-care professionals across many applications. Objective: Evaluate the knowledge on implementation of the safety of diagnostic ultrasound (US) and the extent of perception of users in South King Saudi Arabia (KSA) regarding safety aspects of diagnostic methods. Methodology: This cross-sectional descriptive survey was conducted in Saudi Arabia between October 2019 and September 2020. US operators used an online questionnaire in public and private Hospitals. Data were analyzed using the SPSS software program using appropriate statistical tests. Results: A total of 105 respondents of US operators completed the questionnaires. Most of them specialized in radiology (71.4%), whereas the remaining are physicians and obstetricians. A 50.5% of the US operators responded to the correct answer for US safe in the first trimester, 21.9% responded it is safe in the second trimester, and 34.3% in the third trimester. In comparison between operators about the knowledge safety issue, sonographers have a better knowledge of US safety than others (P = 0.02), whereas females have significant experience than males (P = 0.033). Qualified US operators with postgraduate studies were significantly more knowledgeable about US safety than others (P = 0.04). Conclusions: The qualification of US users has a significant impact on US safety knowledge. Practice and awareness of US safety among US operators in KSA need further training. Further efforts are made to teach and train diagnostic medical US devices to implement safety standards.
Keywords: Knowledge, myocardial infarction, operators, safety, thermal index, ultrasound
|How to cite this article:|
Adam M, Gameraddin M, Alelyani M, Laghbi A, Abdallah I, Alqahtani NA. Assessment of awareness of ultrasound safety among ultrasound users in King Saudi Arabia. King Khalid Univ J Health Sci 2021;6:42-5
|How to cite this URL:|
Adam M, Gameraddin M, Alelyani M, Laghbi A, Abdallah I, Alqahtani NA. Assessment of awareness of ultrasound safety among ultrasound users in King Saudi Arabia. King Khalid Univ J Health Sci [serial online] 2021 [cited 2022 May 27];6:42-5. Available from: https://www.kkujhs.org/text.asp?2021/6/1/42/322883
| Introduction|| |
Ultrasound (US) is an imaging method with significant diagnostic value; it is one of the most important diagnostic tools used by a wide range of health-care professionals across many applications. US has many benefits compared to the other imaging modalities as it is safe, cheap, and accurate such as fluoroscopy, positron emission tomography, computerized tomography, and magnetic resonance imaging. The US is the tool of choice in obstetrics firstly as it is a safe, suitable, and less consuming time (quick) diagnostic procedure. The technical development of US machines using Doppler is associated with potential risks for a client, especially in the first trimester.,
To date, there is no evidence that the diagnostic US causes harm in humans, nor the technical development of US machines using Doppler is associated with potential risks for a client, especially in the obstetrics first trimester., The diagnostic US is pivotal and considered a safe imaging modality. However, recent research has not yet defined the US's bioeffects on humans. Thus, most of the US users thought to depend on this fact.However, some US operators thought that US should be used with high caution. Since the US is a form of energy, there is a possibility for effects in living tissues (bioeffects). Realizing the biological effects should be considered despite the invisible biological effects. However, the present information indicates that the advantage gained from the exercise of diagnostic US incorrect ways exceeds any potential risks due to the increasing range of US studies being performed. US testing has become part of routine care for almost all pregnant women. Continuous power with full technical development is accompanied by potential risk when increased Doppler US use.,
There is a possibility of realizing the biological effects listed set apart, in outlook. However, current information indicates that the advantage gained from the exercise of diagnostic US incorrect ways exceeds any potential risks. Many things raise the potential for biological effects, including (1) US testing has become part of routine care for almost all pregnant women, regardless of potential problems or not; (2) Increase the number of US tests during pregnancy; (3) potential impacts accompany continuous power full technical development; (4) examining by nonspecialists who do not recognize the potential risks and how to reduce them; and (5) Some researchers and doctors expose pregnant women to the US for long periods. Thus, the study aims to assess US safety knowledge during examination among users in Aseer province hospitals and private centers (King Saudi Arabia [KSA]).
| Methodology|| |
A prospective, analytical, descriptive study dealt with US safety assessment in KSA. An online questionnaire was designed to include all the intended variables to satisfy the study. The designed questionnaire was sent to the participants (US operators) by their e-mails and other social media such as WhatsApp. They have completed filling the questionnaire from October 2019 to September 2020. A total of 105 US operators had responded to the questions. The intended questions emphasized issues of US safety.
The participants were asked to examine their knowledge on the following: (1) applying thermal index (TI) and mechanical index in US safety, (2) US safety during first, second, and third trimesters.
The data were analyzed using statistical packages for social sciences (SPSS) Version 23.0 (IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp.). A Chi-square test was used to find an association between the independent and dependent variables. Descriptive statistics were used to describe the qualitative variables as frequency and percentage. P < 0.05 is considered to be statistically significant.
| Results|| |
One hundred and five out of 131 US operators completed the questionnaires with an 80% response rate; most of them specialized in radiology (71.4%), and the remaining (28.6%) are physicians, obstetricians, and nurses. The male-to-female ratio was 1:1.1. Sonographers represented 65.7% and radiologists were 23.8% [Table 1]. They performed approximately 26 cases per day (8000 cases/year). Regarding US Safety, 58.1% of the participants responded well familiar with myocardial infarction (MI), whereas 68.6% were familiar with TI. Regarding MI, females demonstrated significantly good familiarity with MI than males (P = 0.033). Simultaneously, there were no significant differences between males and females regarding their knowledge of TI (P = 0.65), as shown in [Figure 1] and [Figure 2], respectively. The participant's opinions toward US safety during pregnancy revealed that 53 (50.5%) responded the US should be used only for medical reasons in the first trimester. In comparison, 49 (46.7%) showed it is safe but should be used only when medically indicated. In the third trimester, 49 (46.7%) of the participants responded that the US is safe but should be used mainly when medically indicated [Table 2].
|Figure 1: Association of gender with familiarity with the term myocardial infarction|
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|Figure 2: Association of gender with familiarity with the term thermal index|
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Gender and current professions were significant factors affecting knowledge of MI among the participants, P = 0.033 and. 039, respectively. Qualification of the participants has a significant impact on the TI effect (P = 0.04) and does not affect MI knowledge (-value = 0193). In contrast, the participants' specialty had no significant impact on understanding MI and TI, P = 0.315 and 0.358, respectively [Table 3]. Sonographers demonstrated good ability on MI rather than TI compared to nonsonographers (P = 0.02). A total of 33 out of 105 responded they did not know how to manipulate TI and MI during a particular examination. A twenty out of 33 (60%) of sonographers answered that they did not know how to deal with TI and MI during a specific examination [Table 4]. Therefore, there was a significant association of the participants' current profession with US safety knowledge during the examination (P = 0.006), as shown in [Table 4].
|Table 3: Factors affecting knowledge of mechanical index and thermal index among the participants|
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|Table 4: Association of current profession of the participants with knowledge of ultrasound safety during the examination|
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| Discussion|| |
There is a concern regarding US users' knowledge of safety issues. In this study, the response rate was 80%, and most of the responders specialized in radiology (71.4%); they were the US's significant users. There is a continuous trend in the growth of US diagnostic devices' output parameters in the past three decades. Therefore, it is essential to discuss safety since all the diagnostic procedures are based on physical power interactions with biological tissues and associated risks.
The present study revealed that most participants showed that Doppler US should be used only for medical reasons in the first and second trimesters. Their response reflects that they were aware of the Doppler safety in pregnancy. Recent technical development has focused on raising image goodness and Doppler conduct, which has been responsible for the safe. It was reported that Doppler US was a noninvasive means of detecting fetal abnormalities and has revolutionized the management of pregnancies. The issue is that the probe produces heat (hyperthermia), which should be avoided, especially during the uterus's scanning. Another study conducted by Alreshidi et al., who studied imaging modalities and risks, reported that medical students have limited knowledge of the risks of radiation and safety measures.
In this study, gender and current profession significantly impact the knowledge of US safety (P < 0.05). It was observed that females were more knowledgeable than males. They were more familiar with MI than males. It was observed that sonographers were significantly knowledgeable compared to the other professions. On the other hand, there was a significant difference in TI knowledge among the participants (P < 0.05).
The participants' qualification has a significant impact on knowledge of TI compared to MI. This difference is attributed to increasing knowledge in higher studies such as Master's and Ph. D. Sheiner et al. reported a significant number of familiar with US safety issues. These findings indicate variation in knowledge among participants regarding the displayed MI and TI on the sonographic screen during scanning. In contrast, Wasickanin et al. reported that 70% of US obstetric providers did not realize output display standard functions of the equipment. The variation of knowledge of these parameters indicates that the implementation of safety in the US still needs training among the operators.
There was debate regarding US safety; to date, no biological effects were detected at diagnostic levels in laboratory studies for a human. In contrast, several investigators have reported that the US can cause unfavorable health effects on mice., Other reviews said that there were still concerns about the diagnostic US's overall safety and its potential correlation to increased risk of autism spectrum disorders.,,, In general, the significant effects are not well understood on humans.
Overall, most participants know about US safety and parameters to reduce bioeffects in practice.
There were various drawbacks to the study, which does not alter the significance of the findings. First of all, the sample size was not large enough. Second, the questions were not answered entirely. Some participants did not fully consider the importance of the study topic to justify the time spent answering the questionnaire; others did not respond as they were unable due to a high routine overload work. These limitations have not affected the overall significance of the study.
| Conclusions|| |
Gender, qualification of US users have a significant impact on US safety knowledge. Sonographers showed adequate knowledge about US safety compared to nonsonographers. More significant efforts are well needed to increase participants' understanding of the bio-effects of diagnostic US. Further research is required to fill the knowledge gap between practices and US safety.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2]
[Table 1], [Table 2], [Table 3], [Table 4]