Who Is Responsible for Discussing Radiation with Patients?

There is still no consensus regarding who should speak to patients about issues like medical radiation exposure, and radiologists should prioritize development of consensus statements and related novel educational initiatives, according to a review in the American Journal of Roentgenology.

Researchers from California, Massachusetts, Connecticut, and Washington sought to provide a review of the literature regarding awareness and communication of potential radiation-induced cancer risks from medical imaging procedures. They hoped to provide guidance for communicating these potential risks with patients.

The review included literature published from 1995 to 2014 about CT examinations and discussion of radiation dose and radiation-induced cancer risk awareness, informed consent regarding radiation dose, and communication of radiation-induced cancer risks with patients undergoing medical imaging.

There were more than 1,200 references, from which 22 original research articles met their inclusion criteria. Twelve of the studies were about radiation risk awareness among patients and providers. Eight of the 12 studies (67%) surveyed physicians and physicians-in-training and only one separated responses between radiologists and nonradiologists.[[{"type":"media","view_mode":"media_crop","fid":"42132","attributes":{"alt":"radiation","class":"media-image media-image-right","id":"media_crop_7947154709581","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4530","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":"height: 151px; width: 160px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"©Preecha TH/Shutterstock.com","typeof":"foaf:Image"}}]]

Seven studies looked at how radiation risk was shared with the patients by their physicians. Twenty-nine percent of patients (80 of 628 patients) reported that they were informed about radiation risk or dose. In one focus group study of patients in the emergency department, most said that they “rarely” were told about radiation risk or dose. Twenty-two percent of physicians (42 of 192) said they were sharing this information with their patients.

Another study, which surveyed radiology department chairs, found that only 15% (14 of 91) reported that their departments regularly informed patients about radiation risk. When this information was shared, it was most often relayed by radiologic technologists.

The researchers also found that most patients and about half of physicians did not believe in the connection between ionizing radiation from diagnostic CT examinations and increased cancer risks. “With regard to estimation of the comparative magnitude of average effective dose from CT studies relative to chest radiography, both physicians and patients are largely unable to provide reasonable estimates,” they wrote.

Currently, there is also no consensus about who should speak to the patients about radiation risks and what specifically should be related.  “Radiologists should prioritize development of consensus statements and novel educational initiatives with regard to radiation-induced cancer risk awareness and communication,” the researchers concluded.