Implementation of generic and individual justification: Findings from a survey under the IAEA technical cooperation...

The aim of this study is to evaluate the framework and practice of generic and individual justification in countries from the Europe and Central Asia Region supported by the technical cooperation programme (TC) of the International Atomic Energy Agency (IAEA).

The information was obtained by four electronic questionnaires using Google Forms during the 2024. One was distributed to regulatory bodies and three to professional bodies of radiology, nuclear medicine, and dental medicine. The links were sent by mail to representatives from 33 IAEA TC Members States in the region, and a total 85 responses were received from representatives in 24 countries.

Respondents report availability of referral guidelines in only 55-70 % of countries but, where available, guidelines usually include radiation doses and guidance for children and pregnant patients. Clinical information provided by referring practitioners is lacking both for the clinical question and for information from previous procedures, with questions raised as to the completeness of clinical examination before requesting imaging. Radiologists' unencumbered ability to modify or reject a referral for computed tomography was reported by only 13/18 countries (72 %). Underlying issues include difficulties with communication and cooperation between regulatory bodies and professional bodies, limited understanding of regulatory requirements among medical professionals, and limited understanding of clinical practice by regulatory bodies. Good practices in justification were shown in EU countries possibly related to stronger regulation and provision of better clinical information.

Justification problems in the Europe and Central Asia IAEA TC countries, similar to other regions include: low availability and use of referral guidelines; inadequate clinical information for justification; limited time and ability for radiological medical practitioners to amend or reject inappropriate requests; and suboptimal cooperation and communication between regulatory authorities and professionals. Strategies for improvement should address these and may include stronger regulation and better mutual awareness between regulators and professionals, possibly through continuing education, campaigns and collaborative working.