Early Detection of Diseases by Radiological Imaging: New Legal Situation and Evaluation of Service Offers using CT Examinations as an Example. / Früherkennung von Krankheiten mittels radiologischer Bildgebung: Neue Rechtslage und Bewertung von Leistungsangeboten am Beispiel von CT-Untersuchungen.

BACKGROUND: Radiological imaging offers promising prospects for the early detection of diseases. In Germany, the legal framework for such examinations was created by the Radiation Protection Law, which entered into force on December 31, 2018. Under this law, each specific type of radiodiagnostic screening of non-communicable diseases needs an approval on a generic level (permission) by a federal statutory ordinance, defining the specific requirements and conditions. It is the aim of the present paper, (i) to present in detail the new legal situation and (ii) to assess actual service offers for the screening of asymptomatic persons using CT examinations as an example. METHOD: In February 2019, radiology institutions in Germany illegally offering on the Internet CT examinations for the screening of lung and colon cancer or coronary artery disease were identified. For each type of examination, 50 pertinent websites were evaluated particularly regarding the general information on the offered screening examination and the concrete procedure. RESULTS: In the vast majority of cases, the information provided on the websites was inadequate and disproportionately emphasized the benefits over the risks of the screening examination. Moreover, the offers differed substantially with respect to the age and risks factors of potential participants, the frequency of examinations, the screening procedure, and the diagnostic workup. CONCLUSION: The evaluated service offers strongly substantiate the need to define requirements and conditions regarding radiological screening examinations by statutory ordinances, in order to ensure an informed decision of potential screening participants as well as the benefit versus the risks of the procedures. KEY POINTS: · High-evidence studies prove the benefit of radiological screening for some diseases.. · In Germany, screening examinations are only permissible when stated in a federal statutory ordinance.. · At present, only mammography screening for breast cancer is permitted in Germany.. · CT screening examinations currently being conducted in Germany do not fulfill the legal and professional requirements.. · A review process has been initiated regarding possible generic approval of lung cancer screening.. CITATION FORMAT: · Brix G, Nekolla EA, Griebel J. Early Detection of Diseases by Radiological Imaging: New Legal Situation and Evaluation of Service Offers using CT Examinations as an Example. Fortschr Röntgenstr 2020; 192: 139 - 148.

Psicoterapia online: demanda crescente e sugestões para regulamentação / Online psychotherapy: growing demand and suggestions for its regulation / Psicoterapia em línea y sugerencias para la reglamentación

A psicoterapia online é uma forma de psicoterapia, conduzida por meio de sessões síncronas via internet, ainda não permitidas no Brasil, exceto em alguns casos definidos pela resolução 011/2012, do Conselho Federal de Psicologia. Tal restrição é baseada no entendimento de que a pesquisa disponível é insuficiente para autorizar a utilização generalizada desse tipo de serviço. Estudos sobre a aliança terapêutica no atendimento psicológico, fornecido exclusivamente pela internet, mostram que o estabelecimento da relação terapêutica em chamadas online síncronas ocorre de maneira muito parecida com o que acontece em processos terapêuticos face a face, considerando tanto seus benefícios como seus desafios. Este artigo tem como objetivos ampliar a compreensão da psicoterapia online e questionar a sua simples proibição, sinalizando os perigos implicados, vis-a-vis o aumento da demanda para o serviço e seu uso crescente, em desrespeito às restrições atuais. Este artigo também faz sugestões para a regulação do serviço no Brasil.

Online psychotherapy is a form of psychotherapy conducted by means of synchronous Internet sessions that are still not allowed in Brazil, except in a few instances defined by the Resolution 011/2012 of the Federal Council of Psychology. Such restriction is based on the understanding that the research available is insufficient to authorize a wide spread use of this type of service. Studies on therapeutic alliance in psychological care provided exclusively over the internet show that the establishment of the therapeutic relationship in synchronous online calls occurs much like it does in face-to-face therapeutic processes, considering both, its benefits and challenges. This article aims to broaden the understanding of the online psychotherapy and to question its prohibition, signaling the dangers it entails, vis-a-vis the increasing demand for the service and its widespread use in disregard with the current restrictions. This article also makes suggestions for the regulation of the service in Brazil.

Psicoterapia en línea es una forma de psicoterapia realizada por intermedio de sesiones sincrónicas a través de Internet, todavía no permitido en Brasil, excepto en algunos casos definidos por la Resolución 011/2012 del Consejo Federal de Psicología. Esta restricción se basa en la constatación de que la investigación disponible es insuficiente para permitir el uso generalizado de este tipo de servicio. Los estudios sobre la alianza terapéutica en los servicios psicológicos proporcionados exclusivamente por medio de Internet muestran que el establecimiento de la relación terapéutica en las llamadas síncronas en línea es una forma muy parecida a lo que ocurre en los procesos terapéuticos cara a cara, teniendo en cuenta tanto sus beneficios y desafíos. Este artículo tiene como objetivo ampliar la comprensión de la psicoterapia en línea y cuestionar su simple prohibición, señalando los peligros involucrados, vis-a-vis el aumento de la demanda del servicio y su creciente uso en violación de las restricciones actuales. En este artículo también se hace sugerencias para regular el servicio en Brasil.