Wide gap found between ER provider, patient perceptions of radiation dose discussions

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The disconnect over CT radiation discussions between emergency-room providers and the patients they serve may be wider than expected in the Image Wisely era. At one site, a new survey has shown that more than three-quarters of providers thought they’d routinely discussed radiation doses with CT patients—while fewer than one-quarter of patients said they’d been so informed.

Emergency Radiology published the findings online Sept. 26.

Angel Schuster, MD, of Cape Fear Valley Medical Center in Fayetteville, N.C., and colleagues surveyed 101 ER patients who had abdominopelvic CT scans over a two-week period.

The patients were asked whether anyone had spoken with them about the risks and benefits of the CT scan, including radiation dose. The survey also asked the patients to estimate the dose of abdominopelvic CT versus chest x-ray.

The research team sent similar questions to 570 emergency providers as well as 161 radiologists.

Reviewing the responses, Schuster and colleagues found 78 percent of emergency providers (441 of 567) reported routinely discussing radiation dose with patients, while 20 percent of patients (20 of 98) said their emergency provider had discussed radiation dose with them.

Meanwhile, the correct radiation dose range of an abdominopelvic CT was selected by 23 percent of the patients, 39 percent of the providers and 48 percent of the radiologists.

The most commonly reported obstacles to risk/benefit discussions reported by the providers were time limitations and concerns over dissuading the patient from undergoing the CT, the authors report.

“Patients and providers in 2015 appear to be more aware of radiation dose from CT than they were in 2004,” the year a benchmarking survey on radiation dose perceptions came out, Schuster et al. conclude. “Discussion of CT scan radiation exposure and associated risks only occurs sometimes and may actually occur less frequently than perceived by emergency providers.”