If Radiologists Don’t Talk About Imaging, The Internet Will

There is a substantial gap between patient expectations and current practices for providing information about radiological medical imaging tests, according to a study published in the journal Radiology.

Researchers from Memorial Sloan Kettering Cancer Center in New York City, NY, sought to identify areas where patient-centered communication regarding radiological diagnostic imaging tests could be improved.

The researchers reviewed nine hours of transcribed conversations with 30 people who had undergone medical imaging exams. The goal was to determine the participants’ understanding of the benefits and risks associated with various medical imaging procedures, as well as their expectations regarding communication of those benefits and risks.

The participants included:

• Patients undergoing treatment for metastatic colorectal carcinoma

• Women treated within the previous six months for early-stage breast carcinoma

• Men undergoing surveillance after testicular cancer treatment

• Parents of patients treated for stage I–III neuroblastoma

• Patients in a thoracic oncology survivorship program

• Participants in a lung cancer screening program

While most participants did understand the benefits and needs related to imaging, as demonstrated by comments such as “That CT saved my daughter’s life,” and “I’d rather have the radiation dosage than being opened up,” they reported that most of their information was obtained by self-directed Internet research, not through discussions with their physician. This was expressed in comments, such as “If you don’t ask, nobody is going to tell you anything.”[[{"type":"media","view_mode":"media_crop","fid":"33950","attributes":{"alt":"Raymond H. Thornton, MD","class":"media-image media-image-right","id":"media_crop_8575342101710","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"3597","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"float: right; height: 107px; width: 160px; border-width: 0px; border-style: solid; margin: 1px;","title":"Raymond H. Thornton, MD","typeof":"foaf:Image"}}]]

“Interest in having more information and participating in decision making about medical imaging clearly increased as patients transitioned from active cancer treatment to survivorship,” lead author Raymond H. Thornton, MD, interventional radiologist at MSKCC, said in a release. “Cancer survivors typically focus on healthful living and risk-factor reduction, so they were particularly eager to participate in discussions about potential long-term risks of radiation.”

The participants also expressed a desire to be told information such as:

• The rationale for ordering specific imaging examinations

• Intervals for follow-up imaging

• Testing alternatives

“This may not be what we in the medical field want to hear, but I think it’s important that we hear it,” senior author Jennifer Hay, PhD, said in the same release. “Patients want this information, and they prefer to receive it from doctors they know and trust.”