ED Patient Knowledge, Physician Communication on CT Scans
ED Patient Knowledge, Physician Communication on CT Scans
Objectives This study evaluated several aspects of patients' and providers' knowledge and attitude regarding emergency CT scan use. Specifically, is patient awareness of radiation risks changing over time and do levels of education affect this knowledge? Meanwhile, do emergency medicine providers discuss risks with patients and do patients want to know about these risks?
Methods We conducted a survey of clinically stable patients in the emergency department (ED) after undergoing a CT scan.
Results 200 patients were surveyed. 82 (41%) were aware that CT scans are associated with radiation exposure. 50 (25%) patients were aware that radiation from CT can increase overall lifetime risk of cancer compared with only 2/76 (3%) conducted in 2002. 29 (14.5%) providers specifically discussed radiation risk with patients prior to the CT. There was a significant trend towards knowledge that CT uses x-rays among those with more education. However, there was no association between level of education and knowledge of cancer risk associated with radiation risk from CT. 82 (41%) would have liked more information regarding radiation risks from the provider.
Conclusions ED patient knowledge has increased significantly over the past 8 years. At the same time, there is a trend towards ED providers more commonly discussing these risks. Level of education is associated with knowledge that CT uses x-rays, but not with knowledge that this is associated with a greater risk of cancer. Patients often want to be informed of these risks.
CT is very commonly used in the emergency department (ED) as a diagnostic imaging tool where its usage in the USA has increased from 3 million scans a year in 1980 to more than 85 million in 2011. The benefits of CT are clear—within minutes, numerous life-threatening conditions can be diagnosed or excluded.
However, there is a growing awareness of the public health risk that the radiation from medical imaging represents. CT scans and other medical imaging now represent more than half of the annual per capita radiation exposure of the general public in the USA. As more attention is given to this topic in the medical literature, physicians and healthcare providers are becoming more aware of these issues.
Although these studies have been presented in the popular media, it is unclear whether awareness is improving among patients. Several articles in the past decade have evaluated patient awareness.
In 2002, a hospital based study was conducted in a similar setting to our institution at Yale University ED, to determine patient, doctor and radiologist awareness of CT scan risks. They found that only 7% of patients were informed about potential risks and benefits of having a CT scan performed and only 3% of patients believed there was an increased risk for cancer. Other studies in 2009 and 2011 likewise showed little awareness of cancer risks.
Assessing patient knowledge of CT risks and, perhaps more importantly, their desire to be informed is important. This could help determine the need for physicians to discuss CT risks so as to support patient autonomy.
Our primary goal was to determine if increasing attention in both the medical literature and lay press may have increased the public knowledge about the radiation exposure and cancer risks associated with CT scans and to determine if education level affects this knowledge. Additionally, we wanted to examine if ED providers are discussing CT scan risks and if patients even want to know about these possible radiation risks.
Abstract and Introduction
Abstract
Objectives This study evaluated several aspects of patients' and providers' knowledge and attitude regarding emergency CT scan use. Specifically, is patient awareness of radiation risks changing over time and do levels of education affect this knowledge? Meanwhile, do emergency medicine providers discuss risks with patients and do patients want to know about these risks?
Methods We conducted a survey of clinically stable patients in the emergency department (ED) after undergoing a CT scan.
Results 200 patients were surveyed. 82 (41%) were aware that CT scans are associated with radiation exposure. 50 (25%) patients were aware that radiation from CT can increase overall lifetime risk of cancer compared with only 2/76 (3%) conducted in 2002. 29 (14.5%) providers specifically discussed radiation risk with patients prior to the CT. There was a significant trend towards knowledge that CT uses x-rays among those with more education. However, there was no association between level of education and knowledge of cancer risk associated with radiation risk from CT. 82 (41%) would have liked more information regarding radiation risks from the provider.
Conclusions ED patient knowledge has increased significantly over the past 8 years. At the same time, there is a trend towards ED providers more commonly discussing these risks. Level of education is associated with knowledge that CT uses x-rays, but not with knowledge that this is associated with a greater risk of cancer. Patients often want to be informed of these risks.
Introduction
CT is very commonly used in the emergency department (ED) as a diagnostic imaging tool where its usage in the USA has increased from 3 million scans a year in 1980 to more than 85 million in 2011. The benefits of CT are clear—within minutes, numerous life-threatening conditions can be diagnosed or excluded.
However, there is a growing awareness of the public health risk that the radiation from medical imaging represents. CT scans and other medical imaging now represent more than half of the annual per capita radiation exposure of the general public in the USA. As more attention is given to this topic in the medical literature, physicians and healthcare providers are becoming more aware of these issues.
Although these studies have been presented in the popular media, it is unclear whether awareness is improving among patients. Several articles in the past decade have evaluated patient awareness.
In 2002, a hospital based study was conducted in a similar setting to our institution at Yale University ED, to determine patient, doctor and radiologist awareness of CT scan risks. They found that only 7% of patients were informed about potential risks and benefits of having a CT scan performed and only 3% of patients believed there was an increased risk for cancer. Other studies in 2009 and 2011 likewise showed little awareness of cancer risks.
Assessing patient knowledge of CT risks and, perhaps more importantly, their desire to be informed is important. This could help determine the need for physicians to discuss CT risks so as to support patient autonomy.
Our primary goal was to determine if increasing attention in both the medical literature and lay press may have increased the public knowledge about the radiation exposure and cancer risks associated with CT scans and to determine if education level affects this knowledge. Additionally, we wanted to examine if ED providers are discussing CT scan risks and if patients even want to know about these possible radiation risks.
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