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Radiation in Medicine: A Need for Regulatory Reform
One technical panel, which included outside experts and representatives from professional societies, focused on quality of care issues generally and the NRC's "quality management (QM) rule" specifically. Quality of care issues (both processes of care and patient outcomes such as mortality and morbidity) in situations involving radionuclides and in circumstances involving other high-technology diagnostic and therapeutic interventions were discussed at a specially convened meeting (see Appendix I for a list of participants).
The committee commissioned several background or technical papers, to supplement the fact-finding it pursued through workshops and site visits (titles and authors of papers can be found in Appendix J). The topics of these background documents included regulatory issues, risk estimation pertaining to low-level radiation exposure, history of radiation medicine, misadministrations, and perception of risk.
Groups of three or four committee members and one or two IOM staff made four regional site visits to state regulatory agencies and to major facilities or institutions that use radionuclides. Each site visit involved visits to multiple hospital, county, and state offices and meetings with individual practitioners. Two site visits took place in Agreement States (Georgia and California) and two in Non-Agreement States (Minnesota and Massachusetts12). The site visits were intended to provide representative information from across the nation, and the data gathered from them are not to be regarded as a systematic or comprehensive basis for quantitative analysis.
Attendance by appropriate study staff or committee members at selected professional meetings in 1994 and 1995 provided additional background information and facilitated briefings about the project. Among the specific meetings attended were those of the American College of Nuclear Physicians, American College of Radiology, American Roentgen Ray Society, American Society for Therapeutic Radiology and Oncology, Association of Health Services Research, Association of University Radiologists, Conference of Radiation Control Program Directors, Isotopics, National Council on Radiation Protection and Measurements,
Massachusetts is in the process of becoming an Agreement State.