Patient Perceptions of Computed Tomographic Imaging and Their Understanding of Radiation Risk and Exposure (original) (raw)
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Clinical and Experimental Emergency Medicine, 2015
Objective Use of computed tomography (CT) continues to increase, but the relatively high radiation doses associated with CT have raised health concerns such as future risk of cancer. We investigated the level of awareness regarding radiation doses and possible risks associated with CT in medical personnel (MP). Methods This study was conducted from April to May 2012 and included physicians and nurses who worked in the emergency department of 17 training hospitals. The questionnaire included measurement of the effect of CT or radiography on health using a 10-point numerical rating scale, estimation of the radiation dose of one abdominal CT scan compared with one chest radiograph, and perception of the increased lifetime risk of cancer associated with CT. Results A total of 354 MP participated in this study: 142 nurses, 87 interns, 86 residents, and 39 specialists. Interns were less aware of the effects of CT or radiography on health than other physicians or nurses (mean ±SD of 4.8 ±2.7, 5.9 ±2.7, 6.1 ±2.7, and 6.0 ±2.2 for interns, residents, specialists, and nurses, respectively; P < 0.05). There was a significant difference in knowledge about the relative radiation dose of one abdominal CT scan compared with one chest radiograph between physicians and nurses (48.6% vs. 28.9% for physicians vs. nurses, P < 0.05). MP perceived an increased risk of cancer from radiation associated with CT. Conclusion MP perceive the risk of radiation associated with CT, but their level of knowledge seems to be insufficient.
In order to personalize the communication of the CT risk, we need to describe the risk in the context of the clinical benefit of CT, which will generally be much higher, provided a CT scan has a well-established clinical indication. However as pediatric radiologists we should be careful not to overstate the benefit of CT, being aware that medico–legal pressures and the realities of health care economics have led to overutilization of the technology. And even though we should not use previously accumulated radiation dose to a child as an argument against conducting a clinically indicated scan (the " sunk-cost " bias), we should consider patients' radiation history in the diagnostic decision process. As a contribution to future public health, it makes more sense to look for non-radiating alternatives to CT in the much larger group of basically healthy children who are receiving occasional scans for widely prevalent conditions such as appendicitis and trauma than to attempt lowering CT use in the smaller group of patients with chronic conditions with a limited life expectancy. When communicating the CT risk with individual patients and their parents, we should acknowledge and address their concerns within the framework of informed decision-making. When appropriate, we may express the individual radiation risk, based on estimates of summated absorbed organ dose, as an order of magnitude rather than as an absolute number, and compare this with the much larger natural cancer incidence over a child's lifetime, and with other risks in medicine and daily life. We should anticipate that many patients cannot make informed decisions on their own in this complex matter, and we should offer our guidance while maintaining respect for patient autonomy. Proper documentation of the informed decision process is important for future reference. In concert with our referring physicians, pediatric radiologists are well-equipped to tackle the complexities associated with the communication of CT risk, a task that often falls upon us, and by becoming more involved in the diagnostic decision process we can add value to the health care system.
Knowledge and Awareness of CT Radiation Dose and Risk Among Patients
Journal of Diagnostic Medical Sonography
The study aims to assess the level of patients’ awareness and knowledge regarding radiation and dosage along with the associated risks from computed tomography (CT) scan. This cross-sectional study used questionnaires, which were distributed to the diagnostic imaging departments of six large local hospitals in Jordan between September 2014 and March 2015. A total of 600 patients completed the questionnaire, out of which, 52.33% of respondents were female and 47.6% male. The findings show insignificant effects of gender on patient’s knowledge ( P = .596) and significant effect of employment and profession on positive scores ( P = .000). Similarly, no statistical differences were found between gender and correct answers ( P = .707). This cohort of patients demonstrated a lack of awareness and knowledge about the use of ionizing radiation for diagnostic imaging. Thus, there may exist a similar lack of information that will require imaging professionals to raise patients’ awareness and ...
American Journal of Roentgenology, 2012
any diagnostic imaging examinations involve exposure to ionizing radiation from radioactive materials or x-rays. The primary risk associated with ionizing radiation is cancer [1-4]. The exposure from medical radiation is, by far, the greatest artificial source of radiation to the general population [5]. The per capita radiation dose from medical exposures in the United States increased from 0.67 mSv/year in 1980 to over 3 mSv/ year in 2005. CT scans are largely responsible for this dramatic increase [6-11]. From 1980 to 2005, CT scan usage increased from 3 million to 60 million scans. This is out of proportion to population growth; a 50% growth in the U.S. population was accompanied by a 600% increase in medical exposure to radiation [5]. Although the risk for any one person is not large, increased radiation
Patient Perceptions and Knowledge of Ionizing Radiation From Medical Imaging
JAMA Network Open
IMPORTANCE Although imaging has become a standard tool of modern medicine, its widespread use has been paralleled by an increasing cumulative radiation dose to patients despite technological advancements and campaigns calling for better awareness and minimization of unnecessary exposures. OBJECTIVE To assess patients' knowledge about medical radiation and related risks. DESIGN, SETTING, AND PARTICIPANTS A survey study of hospitals in Italy was conducted; all patients in waiting rooms for medical imaging procedures before undergoing imaging examinations at 16 teaching and nonteaching hospitals were approached to take the survey. The survey was performed from June 1, 2019, to May 31, 2020. MAIN OUTCOMES AND MEASURES Survey respondents' basic knowledge of ionizing radiation levels and health risks, earlier imaging tests performed, and information and communication about radiation protection issues. RESULTS Among 3039 patients invited to participate, the response rate was 94.3% (n = 2866). Participants included 1531 women (53.4%); mean (SD) age was 44.9 (17.3) years. Of the 2866 participants, 1529 (53.3%) were aware of the existence of natural sources of ionizing radiation. Mammography (1101 [38.4%]) and magnetic resonance imaging (1231 [43.0%]) were categorized as radiation-based imaging modalities. More than half of the 2866 patients (1579 [55.1%]; P = .03) did not know that chest computed tomography delivers a larger dose of radiation than chest radiography, and only 1499 (52.3%) knew that radiation can be emitted after nuclear medicine examinations (P = .004). A total of 667 patients (23.3%) believed that radiation risks were unrelated to age, 1273 (44.4%) deemed their knowledge about radiation risks inadequate, and 2305 (80.4%) preferred to be informed about radiation risks by medical staff. A better knowledge of radiation issues was associated with receiving information from health care professionals (odds ratio [OR], 1.71;
PLOS ONE
We aimed to evaluate the population's awareness about the radiation exposure associated with five specific imaging tests, and their preference regarding three different formats for receiving the information before undergoing an imaging test. Methods A quantitative and qualitative evaluation through a survey and focal groups including general population from two health departments in Spain. The sampling was carried out in stages (according to health department size) and stratified by age and sex, to get a representative sample. We randomly selected the participants from these stages to be contacted by telephone by a trained nurse. Oral informed consent was obtained. Results Of 602 participants in the quantitative survey, 418 (70.3%) stated that they were aware of the risk associated with radiation. While the majority of these 418 participants knew that xrays involve radiation (85.4%), fewer were aware that CT (42%) and mammography (38%) also involve radiation, and a substantial proportion believed, incorrectly, that MRI (38%) and ultrasound (18.4%) expose patients to radiation. The population preference was to receive the information using both oral and written formats, accompanied by a table showing the equivalence of the radiation associated with the imaging test to either a number of chest Xrays and exposure number of days of background radiation.
Oncology Patient Perceptions of the Use of Ionizing Radiation in Diagnostic Imaging
Journal of The American College of Radiology, 2016
Purpose: To measure the knowledge of oncology patients regarding use and potential risks of ionizing radiation in diagnostic imaging. Methods: A 30-question survey was developed and e-mailed to 48,736 randomly selected patients who had undergone a diagnostic imaging study at a comprehensive cancer center between November 1, 2013 and January 31, 2014. The survey was designed to measure patients' knowledge about use of ionizing radiation in diagnostic imaging and attitudes about radiation. Nonresponse bias was quantified by sending an abbreviated survey to patients who did not respond to the original survey. Results: Of the 48,736 individuals who were sent the initial survey, 9,098 (18.7%) opened it, and 5,462 (11.2%) completed it. A total of 21.7% of respondents reported knowing the definition of ionizing radiation; 35.1% stated correctly that CT used ionizing radiation; and 29.4% stated incorrectly that MRI used ionizing radiation. Many respondents did not understand risks from exposure to diagnostic doses of ionizing radiation: Of 3,139 respondents who believed that an abdominopelvic CT scan carried risk, 1,283 (40.9%) believed sterility was a risk; 669 (21.3%) believed heritable mutations were a risk; 657 (20.9%) believed acute radiation sickness was a risk; and 135 (4.3%) believed cataracts were a risk. Conclusions: Most patients and caregivers do not possess basic knowledge regarding the use of ionizing radiation in oncologic diagnostic imaging. To ensure health literacy and high-quality patient decision making, efforts to educate patients and caregivers should be increased. Such education might begin with information about effects that are not risks of diagnostic imaging.