Informed consent for stochastic effects of ionising radiation in diagnostic imaging.

The ethical and legal principles underpinning the requirement for informed consent for medical procedures are widely accepted. A recent BJR article has applied these principles to the issue of consent to ionising radiation (IR) from diagnostic imaging (DI), but the authors chose to put aside the practical problems associated with this. These problems should not be underestimated and arise from: uncertainties about the existence and magnitude of risk of stochastic effects of IR exposure in DI; the delayed manifestation of its effects; the heterogeneity of risk related to factors associated with individual sensitivity to IR, and dose variation even within examination classes and across clinical indications; and the difficulty of communication of these uncertainties and variations to patients.

Diagnostic imaging: Doing the right thing.

Inappropriate diagnostic imaging (DI) is a burgeoning issue and embraces its overuse and its misapplication. The obverse problem is one of underuse - that is when patients who should undergo imaging fail to do so. This article attempts to define these problems, examines the causes and effects and suggests some potential solutions.

Painless Visible Haematuria in Adults: An Algorithmic Approach Guiding Management.

There is consensus that visible haematuria may be a sign of serious underlying disease, including malignancy, and warrants a thorough diagnostic evaluation. This is usually undertaken by a combination of clinical examination, cystoscopic evaluation, and urinary tract imaging. A decision support tool has been developed in the form of an algorithmic flow chart as part of a suite of on-line evidence-based and consensus-based guidelines Diagnostic Imaging Pathways (DIP): www.