February 16, 2018
Among patients undergoing an imaging test, 78% said they lacked basic information about the procedure before the test itself, researchers report.
"This means one in five people are showing up for the exam without any information about the test they are getting," lead author Jay K. Pahade, MD, an associate professor of radiology at the Yale School of Medicine in New Haven, Connecticut, said in a press release. "This is an important finding in today's healthcare system, where we want more patient engagement and involvement."
Pahade and colleagues gave patients and caregivers a 24-item survey at three pediatric and three adult hospitals in six geographically diverse states between January and May 2015 to find out their preferences for receiving information on imaging before an exam and which information they found most helpful. Of 1742 surveys, 1542 (89%) were returned.
Just more than half of patients (52%) said they sought information themselves, Pahade and colleagues report in an article published online February 13 in Radiology. The most common places they looked were the ordering provider's office (34%) and websites (31%).
Most Want the Information From the Ordering Provider
Most respondents (72%) wanted to receive information from the ordering provider, as opposed to other providers, and most (64%) reported that they did receive it that way. Another 21% preferred getting the information from the test center, and only 9% wanted to receive it from the person administering the test.
"Given that patients prefer to receive information from their provider, radiology organizations may wish to promote their patient information sites directly to the provider in addition to the patient or caregiver," the authors write.
When asked about how they wanted to receive the information about an upcoming test, most (52%) patients preferred a telephone call, followed by in-person communication (37%).
Those who underwent scheduled magnetic resonance imaging (MRI) or nuclear medicine exams were more likely to receive information before an exam (87% MRI, 83% nuclear [P < .001] vs other examination types). Slightly more education was also linked to greater likelihood of getting the information (14.7 ± 2.7 years [standard deviation] vs 14.3 ± 2.8 years; P = .008).
Survey results showed patients also care more about preparation for the test than about getting information on radiation exposure. Respondents most often gave the highest importance scores (4 or higher on a Likert 5-point scale) for information on preparing for the exam (74%), followed by information on the necessity of the test (71%). Patients were least likely to give that rating for information regarding whether an alternative, radiation-free test could be used (54%).
Pahade said that might indicate a need to shift the focus of information. "These results show that what we as radiologists think patients value is not necessarily what they actually value," he said.
More broadly, communication with patients has often focused on the results and less on engaging patients before and during the exams, the researchers say, adding that efforts are under way to boost engagement.
"Radiology initiatives such as Image Gently, Image Wisely, and EuroSafe have taken steps to increase patient engagement and knowledge prior to an imaging procedure by suggesting questions patients might ask their physician or radiologist," they write.
However, the authors note that the questions focus more on radiation exposure, when patients have indicated they are more concerned that the test will help the radiologist make the right diagnosis.
Multivariate logistic regression was used to assess links between responses and demographics.
Coauthors report grants from Siemens and Toshiba and the Medical Imaging and Technology alliance, serving on the speakers' bureau for Educational Symposia International, and receiving royalties from Elsevier and consulting fees (coauthor's institution) from Guerbet, all outside this work.