Risk analysis in patient-specific therapy for hyperthyroidism in Cuba

Abstract

Introduction: In Cuba, there are plans to conduct patient-specific therapy for hyperthyroidism. A methodology and computational tools have been developed for this purpose. Risk analysis will allow us to undertake this practice with quality and safety. Objective: To analyze the radiological risks in the patient –specific therapy for hyperthyroidism in Cuba. Material and Methods: The generic patient-specific Nuclear Medicine model was reviewed and adapted. Inherent and residual risk were determined with the Cuban code SECURE MR-FMEA version 3.0; the stages of the process, the initiating events, the most contributing measures and causes, and the consequences for the exposed groups were identified. Results: A high level of risk was obtained, which was controlled with additional measures. The most significant stages are the acquisition of pre- and post-treatment images, and the preparation of the radiopharmaceutical. The most important preventive measures are: maintaining a moderate workload of the staff, and the training of the medical physicist and the specialists who perform the project reviews at the stages in service design. Patients have very high consequences in 10,7 % of accidental sequences. However, the workers and the public show average consequences at 29 % and 16 %, respectively. Non-compliance with practices, protocols, procedures or standards is the predominant underlying cause of failure. Conclusions: Decision-making for the implementation of patient-specific therapy for hyperthyroidism in Cuba, based on the use of the methodology proposed in this research, is facilitated.

Keywords

• riesgos por radiación
• terapia paciente específica, hipertiroidismo, matriz de riesgo, análisis de modos y efectos de fallo.