Emergency Department Patient Knowledge, Opinions, and Risk Tolerance Regarding Computed Tomography Scan Radiation

Youssef, Nadine A.; Gordon, Andrew; Moon, T.; Patel, Bharvi D.; Shah, Sharan; Casey, Erin M.; McGowan, Andrew J.; Weiner, Scott G.

doi:10.1016/j.jemermed.2013.07.016

Cited by 22 publications

(14 citation statements)

References 20 publications

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“…Thus, patients may have a general expectation that all physicians participating in their care will be available for consultation, or patients may simply be at greater ease once they have had direct human interaction with the doctor interpreting their images. Such findings are consistent with past studies that report a desire by patients to receive more information regarding radiologic testing directly from their health care providers [10,12,13]. Finally, our data do not make clear why patients undergoing imaging to follow-up on a known cancer were less likely to wish to meet with the radiologist before the examination.…”

Section: Discussionsupporting

confidence: 71%

“…However, reaching this goal may be challenging given that the physicians who order radiologic tests are typically not the same physicians who perform and interpret the tests; this situation creates a potential gap in patient communication that may result in a deficit in their understanding of these areas. For instance, past studies show that patients have incomplete knowledge regarding radiation exposure and risk from CT [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Survey-Based Assessment of Patients’ Understanding of Their Own Imaging Examinations

Rosenkrantz

Flagg

2015

Journal of the American College of Radiology

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Section: Discussionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Survey-Based Assessment of Patients’ Understanding of Their Own Imaging Examinations

Rosenkrantz

Flagg

2015

Journal of the American College of Radiology

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“…9,10,29,44 It is our hope that these data on actual ED patients, including complete follow-up information, can help lead to appropriate adoption of reduced-dose CT protocols, as well as enhance physician awareness of dose issues. [45][46][47] We have reported our dosing as size-specific dose estimates, as recommended by the American Association of Physicists in Medicine. These estimates account for the fact that larger patients receiving the same radiation would have a lower organ dose.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Reduced-Dose Computed Tomography for Ureteral Stones in Emergency Department Patients

Moore

Daniels

Ghita

et al. 2015

Annals of Emergency Medicine

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Study objective-Reduced-dose computed tomography (CT) scans have been recommended for diagnosis of kidney stone but are rarely used in the emergency department (ED) setting. Test characteristics are incompletely characterized, particularly in obese patients. Our primary outcome is to determine the sensitivity and specificity of a reduced-dose CT protocol for symptomatic ureteral stones, particularly those large enough to require intervention, using a protocol stratified by patient size.Methods-This was a prospective, blinded observational study of 201 patients at an academic medical center. Consenting subjects underwent both regular-and reduced-dose CT, stratified into a high and low body mass index (BMI) protocol based on effective abdominal diameter. Reduceddose CT scans were interpreted by radiologists blinded to regular-dose interpretations. Follow-up for outcome and intervention was performed at 90 days.Results-CT scans with both regular and reduced doses were conducted for 201 patients, with 63% receiving the high BMI reduced-dose protocol. Ureteral stone was identified in 102 patients (50.7%) of those receiving regular-dose CT, with a ureteral stone greater than 5 mm identified in 26 subjects (12.9%). Sensitivity of the reduced-dose CT for any ureteral stone was 90.2% (95% confidence interval [CI] 82.3% to 95.0%), with a specificity of 99.0% (95% CI 93.7% to 100.0%). For stones greater than 5 mm, sensitivity was 100% (95% CI 85.0% to 100.0%). Reduced-dose CT identified 96% of patients who required intervention for ureteral stone within 90 days. Mean * Corresponding Author. Chris.Moore@yale.edu, Twitter: Chris.Moore@Yale_EUS. Author contributions: CLM, MG, and GPG conceived the study and designed the trial. CLM, DS, and CPG obtained research funding.CLM and SL supervised the conduct of the trial and data collection. SL participated in recruitment of patients. GG performed overreadings of the CT scans in the trial. CLM, SL, and AM managed the data, including quality control. AM and CPG provided statistical advice. BD, GG, AM, DS, and CPG provided advisement on study design and methodology. CLM, SL, AM, and CPG analyzed the data. CLM drafted the article, and all authors contributed substantially to its revision. CLM takes responsibility for the paper as a whole.Presented as an abstract at the Society for Academic Emergency Medicine annual meeting, May 2013, Atlanta, GA.The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the AHRQ. HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript reduction in size-specific dose estimate was 18.6 milligray (mGy), from 21.7 mGy (SD 9.7) to 3.4 mGy (SD 0.9). Conclusion-CT

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“…Yet even the most recent surveys in the medical literature disclose that patients still have poor knowledge of radiation risks (33)(34)(35). In a recent large cohort prospective survey of parents whose children presented to a tertiary care pediatric emergency department with a head injury, 90% of parents wished to be informed of potential cancer risks from CT (36).…”

Section: Head Injuries My Daughter Also Had a Barium Procedures Perfomentioning

confidence: 99%

Debriefing the Brief: It is Time for the Provision of Informed Consent before Pediatric CT

Armao¹,

Ja²,

Semelka³

2015

Radiology

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Emergency Department Patient Knowledge, Opinions, and Risk Tolerance Regarding Computed Tomography Scan Radiation

Cited by 22 publications

References 20 publications

Survey-Based Assessment of Patients’ Understanding of Their Own Imaging Examinations

Survey-Based Assessment of Patients’ Understanding of Their Own Imaging Examinations

Accuracy of Reduced-Dose Computed Tomography for Ureteral Stones in Emergency Department Patients

Debriefing the Brief: It is Time for the Provision of Informed Consent before Pediatric CT

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