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Scan Patients: ‘Radiation? What Radiation?’

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Judging from the results of a small study published online Monday in JAMA Internal Medicine (formerly Archives of Internal Medicine), most imaging patients are pretty clueless about the risks of radiation from imaging.

Or, as Angela Mills, MD, put it:

It’s really a physician’s job to explain to a patient what the risks and benefits are … and sometimes we need to do a better job.

Dr. Mills was not involved in the study but was asked by Reuters Health to comment on it. She is an associate professor of emergency medicine at the Hospital of the University of Pennsylvania in Philadelphia.

From February through December 2011, the researchers surveyed 235 patients who were undergoing nonemergency outpatient CT or cardiac SPECT scans. More than one third of the patients—34 percent—did not know that the scan exposed their body to radiation, and 51 percent recalled seeing or hearing nothing in the media over the previous year about radiation from medical imaging.

Of the 154 patients who knew that they were getting exposed to radiation, 45 percent said the health care provider who ordered the scan informed them about it. Asked to estimate the dosage, 85 percent of those patients underestimated. Of the 154 patients, 88 percent said they were not worried about radiation from the scan, and only 5 percent said they believed the radiation would increase their lifetime risk of cancer.

“A well-informed patient has an understanding of radiation dose and potential health risks of radiation prior to imaging,” the study authors wrote. “These data suggest that many patients have a limited ability to make well-informed decisions about imaging that involves radiation.”

Any individual scan, of course, involves relatively minimal risk. But unless and until electronic health records are fully implemented and universally accessible, providers may not know a patient’s imaging history and may not have a full understanding of the cumulative risk for that individual.

As Dr. Mills said:

To me the problem is when patients have a problem that either is chronic or they keep having pain or maybe there are alternative ways to diagnose, and patients then need to be better informed what their options are.

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Good grief; has it come to the point that we need to install radiation detectors at landfills?  To find out why a landfill in Colorado did just that, see our Facebook page.

Related seminar: ALARA—CT (As Low As Reasonably Achievable)


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