Attachment B-Module changes-2012-04-03

Attachment B

USRT Post-Pretest Module Changes

April 3, 2012

Based on pretest results and additional input from medical radiation experts, we made a few changes to the questions after they were submitted to OMB in December 2011. Specific changes are noted below (numbers in parentheses represent question numbers in the versions submitted to OMB):

1. For all questions that ask for responses by time period, the time periods were changed to before 1970, 1970-1979, 1980-1989, 1990-2009 in the Core and Fluoroscopically-Guided Procedures Modules. The time periods were not changed in the Nuclear Medicine Procedures Module as the current time periods reflect changes in technology.

2. Items DELETED:

General Questionnaire Module: email address (#6); external beam radiotherapy and ultrasound procedures performed (#13); cervical-thoracic and thoracic-lumbar personal diagnostic radiation exams (#19); liver tumor, bone metastases, cardiac dysfunction, colloid (phosphorus-32), colloid (gold-198) personal radionuclide therapy procedures (#20); job titles for father and mother (#31); brand names for multivitamins (#41); number of years worked rotating night shifts and number of rotating night shifts worked per month (#47)

Nuclear Medicine Procedures Module (name changed to Radioisotope Procedures Module): columns for “Less than once in 6 months” for diagnostic (#4) and therapeutic (#11) procedures; liver/spleen scan and renogram diagnostic radioisotope procedures (#4); plastic shielded syringe (#5d, 7e,12d, 14e), non-lead gloves (#5d, 6d, 7e, 12d), glove boxes (#6d), lead shielded vial (#7e), fume hood (#7e), L-Block (#7e) radiation protection measures; hand used to hold syringe (#7c, 14c); percent time wore finger badge (#16); finger badge worn under leaded gloves (#17)

3. Items ADDED:

General Questionnaire Module: fluoroscopy procedures of chest, upper GI, barium swallow, gallbladder, small bowel, lower GI, pyelogram/IVP/urethrogram, in operating room (#13); chronic bronchitis, emphysema, asthma (#17); pap smear, prostate exam (#33); telephone number (new); time to first cigarette of day and number of days smoke cigarettes per week (new)

Radioisotope Procedures Module: total number of diagnostic procedures of each type (#4); all pancreas scans (#4); moved more than 3 feet away from patient as radiation protection measure (#8b, 9b, 15d)

Additionally, some of the questions have changed order. For instance, the questions “How tall are you without shoes?” and subsequent questions were on page 1 and are now on page 9.