Patients' Role in the Use of Radiology Testing for Common Office Practice Complaints

Abstract

Patients' perceived need for radiological studies was significantly associated with use of those services for outpatients with respiratory problems and low back pain. These findings suggest that patients communicate their wishes to physicians, either directly or indirectly, regarding services they think are necessary. Differences in physicians' adherence to guidelines regarding radiology utilization may in part reflect variations in patients' perceived need for those services. Efforts to educate patients about when radiological studies are medically indicated may be an important complement to practice guidelines or other utilization-related financial incentives.

Impact of clinical decision support on head computed tomography use in patients with mild traumatic brain injury in the ED

“…Although these delayed studies were not associated with any radiologically significant findings, this phenomenon could be associated with increased costs for an additional ED, clinic, or physician visit as well as potential patient anxiety. These follow-up visits may have neutralized some of the initial benefits associated with the decreased CT utilization in the index ED visit and may indicate a need for improved patient-provider communication regarding reasons for follow-up during the initial ED visit [35]. Further studies to examine this potential unintended consequence as well as patient-centered or shared clinical decision making are warranted.…”

Variation and Trends in ED Use of Radiographs for Asthma, Bronchiolitis, and Croup in Children

“…Among these are patient/parent expectations, as was noted in an office-based study in adult Medicare eligible recipients, in which the patient' s perceived need for radiographic studies was significantly associated with increased use of radiographs for respiratory problems and low back pain. 28 Similarly, when physicians perceived that parents expected antibiotic treatment for their child, they prescribed it 62% of the time versus 7% of the time when they did not think antibiotics were expected. 29 Pressures on ED physicians to practice more aggressively could also be involved.…”

Examens radiologiques chez les patients lombalgiques : anxiété du patient ? Anxiété du thérapeute ?

“…Les scores étaient additionnés et transformés de manière linéaire en une échelle de 0 à 100 pour les trois symptômes qui ne concernaient pas le patient. Si l'analyse multivariée indiquait que l'utilisation d'examens radiologiques chez les patients lombalgiques était significativement accrue en présence de caractéristiques cliniques telles qu'une gêne importante due aux douleurs (quartiles 3 et 4) et une ostéoporose, elle montrait que cette utilisation était également significativement accrue chez les patients qui exprimaient un fort degré d'accord avec la nécessité des examens radiologiques (quatrième quartile) [19].…”