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Development of consensus statements for pregnancy screening in diagnostic nuclear medicine: a Delphi study
Daphne J James1, Helen M Warren-Forward2
1School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia daphne.james@newcastle.edu.au.
Unlabelled:
Current radiation protection recommendations do not provide clear guidelines or advice on pregnancy screening strategies for diagnostic nuclear medicine procedures. Previous studies have reported on variations in current practice for pregnancy screening before diagnostic nuclear medicine procedures. The development of consensus statements aims to provide a consistent approach and assist nuclear medicine personnel to confidently question patients about their pregnancy status.
Methods:
The Delphi technique was chosen for the research design. A panel consisting of 10 experienced nuclear medicine personnel from Australia and New Zealand was recruited. Panel members were provided with a summary of existing research. Consensus agreement was predefined as 80%. Questionnaires were developed and distributed to the panel members, with iterative analysis and feedback between survey rounds. Three survey rounds were conducted online using SurveyMonkey between December 2013 and June 2014. The round 1 questionnaire was developed from the results of a previous survey. It consisted of 30 questions designed to gather the opinions of the expert panel. After analysis of the round 1 responses, consensus statements were developed for round 2 and revised in round 3.
Results:
Consensus was achieved for 16 statements. The statements recommend using verbal questioning with patient signature, defining the age range for questioning as 12-55 y, providing advice on the use of pregnancy testing, and questioning potentially difficult groups such as teenagers. A flowchart was included for comment in round 3.
Conclusion:
This was the first Australian study to develop consensus statements and a flowchart to assist nuclear medicine personnel in consistently and confidently questioning patients about their pregnancy status before diagnostic procedures. Implementation of these statements into clinical practice guidelines should reduce the possibility of inadvertent fetal irradiation.
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