Health services research and policy
Original article
Survey-Based Assessment of Patients’ Understanding of Their Own Imaging Examinations

https://doi.org/10.1016/j.jacr.2015.02.006Get rights and content

Abstract

Purpose

To perform a survey-based assessment of patients’ knowledge of radiologic imaging examinations, including patients’ perspectives regarding communication of such information.

Methods

Adult patients were given a voluntary survey before undergoing an outpatient imaging examination at our institution. Survey questions addressed knowledge of various aspects of the examination, as well as experiences, satisfaction, and preferences regarding communication of such knowledge.

Results

A total of 176 surveys were completed by patients awaiting CT (n = 45), MRI (n = 41), ultrasound (n = 46), and nuclear medicine (n = 44) examinations. A total of 97.1% and 97.8% of patients correctly identified the examination modality and the body part being imaged, respectively. A total of 45.8% correctly identified whether the examination entailed radiation; 51.1% and 71.4% of patients receiving intravenous or oral contrast, respectively, correctly indicated its administration. A total of 78.6% indicated that the ordering physician explained the examination in advance; among these, 72.1% indicated satisfaction with the explanation. A total of 21.8% and 20.5% indicated consulting the Internet, or friends and family, respectively, to learn about the examination. An overall understanding of the examination was reported by 70.8%. A total of 18.8% had unanswered questions about the examination, most commonly regarding examination logistics, contrast-agent usage, and when results would be available. A total of 52.9% were interested in discussing the examination with a radiologist in advance. Level of understanding was greatest for CT and least for nuclear medicine examinations, and lower when patients had not previously undergone the given examination.

Conclusions

Patients’ knowledge of their imaging examinations is frequently incomplete. The findings may motivate initiatives to improve patients’ understanding of their imaging examinations, enhancing patient empowerment and contributing to patient-centered care.

Introduction

Shared decision making by patients and physicians contributes to patients experiencing reduced anxiety as well as greater satisfaction, engagement, sense of control, and participation in their own care 1, 2, 3, 4, 5. Past studies report that provision of information to patients is among the most critical steps for achieving shared decision making [6], and that the process entails having patients that are as knowledgeable as possible regarding their management [1]. In addition, in studies of a range of medical conditions, patients have been observed to want greater knowledge regarding their care 4, 7, 8.

Radiologists can contribute to shared decision making by ensuring that patients have a strong understanding of the imaging examinations they undergo. Such understanding includes awareness of the modality of the examination, the body part being imaged, any use of intravenous or other contrast agents, and potential radiation exposure. Obtaining this level of understanding involves providing patients with sufficient opportunity for any questions to be answered by a health care provider who is knowledgeable regarding the examination. 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.

To provide greater insight into patients’ knowledge of radiologic testing, we administered a prospective survey to outpatients undergoing imaging examinations at our institution. We report findings from this assessment of patients’ knowledge regarding radiologic imaging examinations, including their perspectives on the communication of such information. The results of this survey, including factors identified to be associated with patients’ understanding of imaging examinations, could be used to guide future initiatives to improve patient awareness.

Section snippets

Methods

Our institutional review board approved this HIPAA-compliant prospective study. All subjects provided written informed consent. Adult outpatients undergoing radiologic imaging examinations at our institution were given a voluntary survey while in the waiting area before the start of the scheduled examination. Questions were related to knowledge of specific aspects of their examination, as well as their experience in being educated about the examination before their appointment. Most questions

Patients’ Knowledge of Radiologic Imaging Examinations

A total of 97.1% (166 of 171) of patients correctly identified the modality of the scheduled imaging examination. In 4 of the 5 instances in which the patient identified the incorrect modality, a response of CT was provided, rather than MRI, ultrasound, or nuclear medicine. In addition, 97.8% (170 of 174) of patients correctly identified the body part being imaged. (Fig. 1)

Overall, 45.8% (76 of 166) of patients correctly identified whether the examination entailed radiation. A total of 51.1%

Discussion

We performed a prospective survey-based assessment of patients’ knowledge of their scheduled imaging examinations. A reassuring finding is that the overwhelming majority of patients correctly identified the imaging modality being used and the body part being imaged. However, patients less reliably understood other aspects of their examinations. Approximately half of patients incorrectly identified whether their examination entailed radiation exposure, and a substantial fraction of patients were

Conclusions

We have identified key areas of incomplete knowledge by patients regarding their scheduled radiologic examinations, including knowledge of radiation exposure and use of contrast agents. Examinations were not explained consistently to patients in advance, or were not explained satisfactorily, by referring physicians, and patients not uncommonly reported having incomplete understanding as well as remaining unanswered questions about their scheduled examinations. A small majority of patients were

Take-Home Points

  • In a survey of outpatients awaiting radiologic imaging, 45.8% correctly identified whether the examination entailed radiation; 51.1% and 71.4% of patients who were scheduled to receive intravenous or oral contrast, respectively, were aware that it would be administered.

  • A total of 78.6% of patients indicated that the ordering physician explained the examination in advance. Among these, 72.1% indicated satisfaction with the explanation.

  • A total of 21.8% and 20.5% of patients indicated consulting

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The authors have no conflicts of interest to disclose.

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