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After collecting a large number of performance rating assessments in order to enable a set of rating films to be used for training purposes it was decided to analyse the results. This analysis shows that the basic limitations of the rating process still exist and the article discusses two of these in detail. Flatness is seen to be even more pronounced than had heretofore been acknowledged and the variability in concept of standard is seen to be approximately half explained by differences between companies and half by differences between observers within the same company. [ABSTRACT FROM AUTHOR]

Numerous studies have been undertaken to examine the efficacy of Predetermined Motion Time Systems, ranging from those questioning the underlying postulates to those contrasting the P.M.T. value with a physiological norm. An opportunity arose to compare a macroscopic M.T.M. value with a time study evaluation of 105 practising work study officers, the medium used for the comparison being six rating films.
The method of computing the basic time is outlined together with the comparative results which, whilst not validating any particular system, are of interest. [ABSTRACT FROM AUTHOR]

An analysis and review of the fundamental psychological basis of decision making has been undertaken in respect of radiation protection of the patient in medicine. Both clinical and scientific aspects of patient protection have been considered. Every stage of the clinical process of radiological examinations, from referral through to diagnostic outcome, has been shown to be subject to proven psychological effects including biases, framing, anchoring and prospect theory, which deals with perceived gains and losses. Such factors also influence the scientific aspects of radiation protection of the patient. Justification for the use of single dose reference level (DRL) values has employed framing with substitution or manipulation by accessibility in order to promote their usefulness. The use of DRLs as presently proposed constrains a diverse patient population to a reference or representative person. This approach is shown to represent a public health initiative that largely ignores the ethical basis of patient protection inherent in the Hippocratic Oath. [ABSTRACT FROM AUTHOR]

A review of the role and relevance of the principles of radiation protection of the patient in diagnostic radiology as specified by ICRP has been undertaken when diagnostic risks arising from an examination are taken into account. The increase in population doses arising from diagnostic radiology over the past 20 years has been due to the widespread application of higher dose CT examinations that provide significantly more clinical information. Consequently, diagnostic risks as well as radiation risks need to be considered within the patient radiation protection framework. Justification and optimisation are discussed and the limitations imposed on patient protection by employing only a radiation risk framework is highlighted. The example of radiation protection of the patient in breast screening programmes employing mammography is used to highlight the importance of defined diagnostic outcomes in any effective radiation protection strategy. [ABSTRACT FROM AUTHOR]

In 1973, International Commission on Radiological Protection Publication 22 recommended that the acceptability of radiation exposure levels for a given activity should be determined by a process of cost-benefit analysis. It was felt that this approach could be used to underpin both the principle of ALARA as well for justification purposes. The net benefit, B, of an operation involving irradiation was regarded as equal to the difference between its gross benefit, V, and the sum of three components; the basic production cost associated with the operation, P; the cost of achieving the selected level of protection, X; and the cost Y of the detriment involved in the operation: B = V - (P + X + Y). This article presents a theoretical cost-risk-benefit analysis that is applicable to the diagnostic accuracy (Levels 1 and 2) of the hierarchical efficacy model presented by National Council on Radiation Protection and Measurements in 1992. This enables the costs of an examination to be related to the sensitivity and specificity of an X-ray examination within a defined clinical problem setting and introduces both false-positive/false-negative diagnostic outcomes into the patient radiation protection framework. [ABSTRACT FROM AUTHOR]