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The Radiation Injury Severity Classification system: an early injury assessment tool for the frontline health-care provider.

Authors
Kuniak-M; Azizova-T; Day-R; Wald-N; Suyama-J; Zhang-A; Sumina-MV; Pesternikova-VS; Vasilenko-E; Soaita-A; Slaughter-DM
Source
Br J Radiol 2008 Mar; 81(963):232-243
NIOSHTIC No.
20033461
Abstract
Our goal was to adapt current diagnostic methods for radiation overexposure patients into a practical system that can be implemented rapidly and reliably by responders unfamiliar with the effects of radiation. Our Radiation Injury Severity Classification (RISC) system uses clinical and haematological parameters from the prodromal phase of the acute radiation syndrome (ARS) to classify acute radiation injury for purposes of managing treatment disposition. Data from well-documented ARS cases were used to test the RISC system. Three-day summaries were generated for each case. These were individually reviewed by the three physicians most involved with the development of the system to establish both a consensus case score (CCS) and disposition category ranges. 30 volunteer raters from varying health disciplines using the RISC system then each independently rated a random selection of 12 cases for injury severity in a self-trained field-simulation exercise. The CCS identified discrete cut-off ranges for the three disposition categories in both manageable and mass casualty events. The group of raters, after a modest period of self-training, achieved overall levels of pairwise agreement with the CCS category of 0.944 for manageable events and 0.947 for mass casualty situations. In conclusion, an early assessment of the severity of the ARS injury is required for an appropriate disposition determination. The RISC system should produce reasonably accurate and reliable assessments of radiation injury severity within 6-12 hours post exposure despite the probable absence of physical dosimetric data.
Keywords
Epidemiology; Physicians; Radiation-effects; Radiation-exposure; Radiation-hazards; Radiation-injury; Radiation-measurement; Radiation-properties; Radiation-sickness; Radiation-sources; Health-care; Health-care-personnel; Health-programs; Health-services; Training
Contact
Richard Day, PhD, A443 Crabtree Hall, GSPH University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261
CODEN
BJRAAP
Publication Date
20080301
Document Type
Journal Article
Email Address
rdfac@pitt.edu
Funding Type
Grant
Fiscal Year
2008
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-007866
Issue of Publication
963
ISSN
0007-1285
Source Name
British Journal of Radiology
State
PA
Performing Organization
University of Pittsburgh at Pittsburgh
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