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Neither patients nor, apparently, doctors understand the risks of CT scans, according to a research letter published online Monday in JAMA Internal Medicine.

The researchers gave a questionnaire to 286 consecutive patients undergoing CT at the Denver Veterans Affairs Medical Center in November and December 2011. Of the 271 who fully responded, only 37 percent ranked CT as involving a higher radiation exposure than a chest X-ray. Only 53 percent said a CT scan exposed them to more radiation than living a year in Colorado, and 5 percent said CT scans involved no radiation exposure.

Most of the respondents (62 percent) said they believed the final decision about whether to proceed with a CT scan was mainly the physician’s. Only 35 percent said they discussed the risks with their health care provider. And, the study says:

Only 17% (n=46) reported all of the following prior to undergoing the CT scan: having a shared final decision, discussing the potential benefits, and discussing the potential risks with their health care provider.

Tanner J. Caverly, MD, of the internal medicine division at the University of Colorado Denver, is the lead author.

Of the 271 survey respondents, only one correctly ranked CT, living a year in Colorado, a chest X-ray, and MRI correctly in terms of radiation exposure. (For nonradiologists who may be reading this, that’s the correct order, from most to least: CT, Colorado, chest X-ray, MRI.)

Part of the problem, the research letter suggests, is that the patients’ doctors may not have a good grasp of the risks. The letter begins: “Up to 1 in 3 imaging tests in the United States are ordered in situations when the expected benefits do not sufficiently exceed the risks. Unfortunately, studies suggest that clinicians are not well informed about the risks of medical imaging.”

Patrick G. O’Malley, MD, general internal medicine director of Uniformed Services University of the Health Sciences in Bethesda, Maryland, reinforced that in an editor’s note also published online Monday: “It is likely that many physicians also do not know the risks, and so it is not surprising that even when there are discussions with patients about risks and benefits of the procedure, patients clearly still do not understand the true risk of radiation exposure.”

Related seminar: National Diagnostic Imaging Symposium™


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