Avoiding fears and promoting shared decision-making: How should physicians inform patients about radiation exposure from imaging tests?

Abstract

Objective: 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 x-rays 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 X-rays and exposure number of days of background radiation.

Discussion: The general population does not receive enough information regarding radiation exposure and the associated risks related to imaging tests. Initiatives should be designed to reinforce the patient's awareness when ordering a diagnostic imaging test.

Fig 1. Flow diagram of selection procedure.

Fig 2. Percentage of people that associated each particular imaging test with radiation exposure according to that they were awareness of the risk associated with radiation exposure in imaging tests.

a. Participants stated that they were aware of the risk associated with radiation exposure in imaging tests. b. Participants stated that they were not aware of the risk associated with radiation exposure in imaging tests.