WONDER Study — Women Exposed to Occupational Doses of Radiation

About the Study

What is the WONDER Study?

The Women Exposed to Occupational Doses of Radiation (WONDER) study is a first-of-its-kind, prospective national observational study led by Yale School of Medicine and endorsed by SCAI.

WONDER measures real-world surface and under-the-lead (simulated fetal) radiation exposure in female interventional cardiology fellows-in-training and early-career cardiologists across the United States — and gives each participant access to her own data in real time, on demand.

📡

Real-Time On-Demand Dosimetry

Wireless Instadose VUE dosimeters (Mirion Medical) sync via Bluetooth to your phone — check your surface and under-lead doses anytime, without waiting weeks for a report.

📋

Brief Annual Surveys (~15 min)

Yearly questionnaires on knowledge, attitudes, and practices regarding radiation and pregnancy — plus optional pregnancy outcome reporting.

🎓

Annual Education Webinar

Online training covering current evidence and best practices for radiation safety in the cath lab — including during pregnancy.

🔒

Fully Confidential

All data is stored securely using a study-specific de-identified code in REDCap (Yale YCRG). Your radiation data is never shared with your employer or institution.

Our Mission

To fill a critical gap in our understanding of real-world fetal radiation exposure for women in the cath lab — and to use that data to change careers, cultures, and policies for the better. By the women, for the women.

Primary Endpoint

Annual surface & under-lead dose (mSv/µSv) for up to 10 years

Secondary Endpoints

Knowledge & attitude change; real-world pregnancy outcomes

IRB Status

Approved — Yale University School of Medicine

Dosimeter Sponsor

Mirion Medical — $120,000 grant over 3 years

Why It Matters

Radiation fear is keeping women out of interventional cardiology

Despite professional society guidelines deeming cath lab work safe in pregnancy, a lack of accessible personal data perpetuates anxiety and career barriers. WONDER closes that gap.

🚧

Radiation Is a Career Barrier

Concerns about occupational radiation during childbearing remain one of the top reasons women avoid interventional cardiology. As of 2022–23, only ~15.5% of IC trainees were women — just 58 individuals nationally — despite record participation gains.

Yong C et al., JACC Cardiovasc Interv, 2019

📊

Real-Time Data Is an Unmet Need

Fewer than 20% of cardiology fellows know their personal radiation dose. Traditional TLD badge systems create weeks-long delays before data reaches the wearer — leading to disengagement and anxiety. Newer wireless technology changes everything.

Kim C et al., Am J Cardiol, 2010 · Haghighat et al., JAMA Cardiology, 2024

✨

An Opportunity to Drive Change

Real-world radiation and pregnancy outcome data will empower women to make informed career choices, encourage programs to adopt modern dosimetry, and shape policy — at SCAI, across training programs, and beyond. This is research by women, for women.

Fetterly KA et al., J Soc Cardiovasc Angiogr Interv, 2024

Study Design

How the WONDER Study Works

A prospective, multi-center observational cohort enrolling female IC fellows and early-career cardiologists across the U.S. over 5 years, with up to 10 years of follow-up per participant.

Screening & Recruitment (Annual — Jan–May)

Female IC FITs and recent graduates are identified via SCAI and ACGME and contacted about participation. Takes less than 5 minutes to screen.

Electronic Informed Consent (June)

Eligible participants review the study details and sign the consent form electronically — no in-person visit required.

Baseline Entry Survey (June)

Enrolled participants complete an entry survey assessing current knowledge, attitudes, and practices regarding radiation exposure and pregnancy.

Dosimeters Mailed to Your Home (June–July)

Two Instadose VUE dosimeters (Mirion Medical) are mailed directly to you — one collar (surface) and one under-the-lead (simulated fetal) — at no cost.

Continuous Dosimetry (Year-Round, Up to 10 Years)

Wear your dosimeters during cath lab shifts and sync data via the Mirion app. Access your personal dose on-demand, anytime.

Annual Follow-Up: Survey + Webinar (June, Each Year)

A brief ~15 min annual survey captures changes in knowledge, attitudes, and optional pregnancy data. A ~1 hr online educational webinar covers current evidence and best practices.

Study Type

Prospective, Multi-Center Observational Cohort

Enrollment Period

5 Years — June 2025 through June 2029

Follow-Up Duration

Up to 10 Years Per Participant

Target Enrollment

250+ Female IC FITs & Early-Career ICs Nationwide

Dosimeter Technology

Instadose VUE (Mirion Medical) — wireless, Bluetooth, real-time on-demand reads via mobile app

Data Management

REDCap — secure, de-identified. Managed by Yale Cardiovascular Research Group (YCRG)

Important: The WONDER study dosimeters are used in addition to — not instead of — the dosimeters provided by your institution's radiation safety office. Your existing compliance obligations are unchanged.

Participation Criteria

Who Can Join the WONDER Study?

The study is designed for female interventional cardiologists at the start of their careers — those with the most to gain from understanding their real-world radiation exposure.

✓

Inclusion Criteria

✓
Female sex assigned at birth
✓
Currently enrolled in an IC fellowship program (fellow-in-training, FIT)
✓
Graduated within the last 5 years from an accredited IC fellowship program
✓
Currently living and practicing in the United States
✓
Owns a smartphone with Bluetooth for data transmission
✓
Willing to comply with protocol-specified annual follow-up for up to 10 years

✗

Exclusion Criteria

✗
Does not own a smartphone or Bluetooth-capable device for data syncing

Regarding pregnancy: Pregnancy is not an exclusion criterion. If you are currently pregnant or become pregnant at any point during the study, you will continue to participate exactly as non-pregnant participants. Collecting radiation data during pregnancy is among the study's most valuable outcomes.

Not sure if you qualify? Take the brief online screening survey — it takes less than 5 minutes and will tell you immediately whether you meet the criteria. No commitment is required to complete the screening. If you qualify, you'll receive step-by-step enrollment instructions.

How to Participate

Joining Is Simple — Everything Is Online

No in-person visits, no lab work. Just a brief survey and your willingness to contribute to research that will shape the future of interventional cardiology for women.

📋1

Complete Screening Survey

A brief online form to confirm your eligibility. Takes less than 5 minutes.

✍️2

Provide Informed Consent

Review the study details and sign electronically — no printing or mailing required.

📦3

Dosimeters Arrive at Home

Two Instadose VUE dosimeters are mailed directly to you, completely free of charge.

🔬4

Start Contributing Data

Wear your dosimeters in the cath lab, sync via the Mirion app, and complete annual surveys.

Ready to make history?

Join female interventional cardiologists across the country contributing to the first national dataset of its kind. Your data will inform careers, guidelines, and policy for the next generation.

Take the Screening Survey →

FAQ

Frequently Asked Questions

Answers to the questions potential participants ask most often. Still have questions? Email the study team directly.

Female interventional cardiology fellows-in-training (FITs) or early-career interventional cardiologists who graduated from an IC fellowship within the last 5 years, are currently practicing in the United States, and own a smartphone with Bluetooth capabilities.

Day-to-day participation is minimal. You wear two small dosimeters during cath lab shifts and periodically open the Mirion app on your phone to sync your data — this takes about 30 seconds. Once a year, you complete a ~15 minute survey and attend a ~1 hour online educational webinar.

Yes — this is one of the most important features of the study. The Instadose VUE dosimeters provide real-time, on-demand readings via the Mirion smartphone app. Unlike traditional TLD badges that can take weeks to return results, you can check your personal dose at any time.

None. There is absolutely no cost to participants. Study dosimeters are provided free of charge through a $120,000 grant from Mirion Medical and will be mailed directly to your home address.

No. The WONDER study dosimeters are used in addition to — not instead of — the dosimeters provided by your institution's radiation safety office. Your existing institutional compliance obligations remain unchanged.

Absolutely. All participant data is stored in REDCap using a study-specific de-identified code, managed by the Yale Cardiovascular Research Group. Your personal radiation data and survey responses will never be shared with your employer, training program, or institution without your explicit written consent.

Yes. Pregnancy is not an exclusion criterion. If you are currently pregnant or become pregnant at any point during the study, you will continue to participate exactly as non-pregnant participants do. In fact, capturing real-world under-the-lead (simulated fetal) radiation data during pregnancy is one of the study's most valuable secondary objectives.

Yes. The WONDER study has received Institutional Review Board (IRB) approval from Yale University School of Medicine and is conducted in full compliance with FDA regulations, ICH Good Clinical Practice (GCP) guidelines, and the Declaration of Helsinki.

Participants are followed for up to 10 years after enrollment. This long follow-up is what makes WONDER uniquely powerful — capturing career-spanning exposure data and long-term pregnancy outcomes never before systematically collected. You may withdraw at any time; all data collected up to that point will be retained for analysis.

No problem. Since WONDER is conducted entirely remotely — dosimeters by mail, data via smartphone, surveys online — you can continue participating wherever you practice in the United States. Simply notify the study team with your updated mailing address.

You can reach the study team at samit.shah@yale.edu (Dr. Samit Shah, PI) or natalija.odanovic@yale.edu (Dr. Natalija Odanovic, Co-PI). We're happy to answer any questions before you decide whether to participate.

Study Leadership

Meet the Principal Investigators

WONDER is led by dedicated interventional cardiologists at Yale School of Medicine with deep expertise in radiation safety, coronary physiology, and women's cardiovascular health.

Natalija Odanovic, MD

Assistant Professor Adjunct, Yale School of Medicine
Institute for Cardiovascular Diseases "Dedinje," Belgrade

Co-Principal Investigator

Dr. Odanovic graduated from the University of Belgrade Faculty of Medicine and completed her internal medicine residency at Rutgers NJMS, followed by cardiovascular disease and interventional cardiology fellowships at Yale University. She currently practices at the Institute for Cardiovascular Diseases "Dedinje" in Belgrade. Her own experience as a pregnant interventional cardiologist working in the cath lab was the personal inspiration for the WONDER study.

2022Interventional Cardiology Fellowship — Yale University

2021Cardiovascular Disease Fellowship — Yale University

2018Internal Medicine Residency — Rutgers NJMS

2014MD — University of Belgrade Faculty of Medicine

View Yale Profile ↗

Samit Shah, MD, PhD, FACC, FSCAI

Assistant Professor of Medicine, Yale School of Medicine
Director, VA Connecticut Cardiac Catheterization Laboratory

Principal Investigator

Dr. Shah is an interventional cardiologist specializing in coronary artery disease, coronary physiology, and complex coronary interventions at Yale and the VA Connecticut Healthcare System. He is national co-PI of the DISCOVER INOCA multi-center registry, and his research focuses on outcomes of cardiovascular interventions and ischemic heart disease in women.

SCAI "30 Under 40" 2023 Lynda Rosenfeld Teaching Award VA I CARE Award Naratil Pioneer Award

2019Interventional Cardiology Fellowship — Yale New Haven Hospital

2018Cardiovascular Medicine Fellowship — Yale University

2012MD — University of Illinois College of Medicine

2010PhD, Neuroscience — University of Illinois Urbana-Champaign

View Yale Profile ↗

SCAI Endorsement

Backed by the Leading Society in Interventional Cardiology

"I want to help elevate the visibility and participation of women within interventional cardiology and address concerns about radiation exposure... SCAI led the way on developing statements to assure women they could work safely in the cath lab environment should they choose, with the proper monitoring."

— Dawn Abbott, MD, SCAI President
Director of Interventional Cardiology, Brown University Health Cardiovascular Institute

Read the Coverage ↗

🏛️

Official SCAI Endorsement

The Society for Cardiovascular Angiography and Interventions has formally endorsed the WONDER study and is actively supporting participant recruitment and community outreach nationwide.

📧

Direct Outreach to Fellows

SCAI is emailing all eligible IC fellows and contacting program directors nationwide to invite participation, leveraging its full membership reach to maximize enrollment.

♀️

Aligned with SCAI's WIN Initiative

WONDER directly supports SCAI's Women in Innovations (WIN) mission to increase female representation in IC and improve radiation safety standards and awareness.

📰

National Media Coverage

The study has been featured in Cardiovascular Business and promoted through SCAI's social media and professional networks, amplifying reach across the IC community.