Radiation risk awareness lacking in patients, some physicians

Awareness of medical radiation risk needs improvement among patients and their parents or caregivers, according to the results of a Singapore study, which also highlights a mismatch between caregiver expectations and the actual procedure of radiation risk disclosure.

“[W]e found that radiation risk awareness among our patients and their parents/caregivers and physician risk disclosure rates are unsatisfactory,” the researchers said. “Improving our patients’ knowledge and awareness may be challenging, but we should aim to routinely discuss radiation risks with our patients.”

Adolescents and caregivers presenting to a paediatric emergency department (PED) of a tertiary university hospital from December 2015 to May 2016 completed a prospective convenience sample survey. The questionnaire assessed the following: demographic data, knowledge of imaging procedures and radiation risks, and expectations regarding information provided about medical radiation.

A total of 349 questionnaires were accomplished (caregivers, 82.5 percent; adolescents, 17.5 percent). Correctly answered questions numbered at a mean of 6.2±2.4 out of 11. Participants with tertiary education scored better than those without (36.4 percent vs 17.2 percent scoring above the mean; p=0.001). The score was not affected by age, gender, history of previous imaging, and imaging done. [Singapore Med J 2020;doi:10.11622/smedj.2020071]

Of the participants, two-thirds did not associate medical radiation with any negative lifetime risk of cancers or know that different scans had varying amounts of radiation. Most of them were also not aware that the radiation dose in medical imaging is adjusted to a child’s size.

Majority of the patients who underwent imaging (90.1 percent) received explanations on the need for scans, and about one-fourth (26.5 percent) were told of the risks involved. Nearly all participants wanted to be informed of imaging indications as well as risks, and many preferred to learn this from physicians (75.6 percent) or technicians (51.6 percent) rather than educational pamphlets (34.4 percent) or internet resources (22.9 percent).

“As in previous studies, our respondents generally favoured obtaining radiation information from their healthcare provider as compared to written resources such as educational pamphlets and hospital-endorsed internet sites,” the researchers said. “Their preference is understandable, as a face-to-face dialogue allows for a more personalized discussion on individual risks instead of population risks.” [J Med Imaging Radiat Oncol 2013;57:38-44; Eur Radiol 2016;26:436-443]

Several studies found that patients and their families are eager to learn about possible radiation risks, and physicians agreed that such discussions are warranted. [Eur Radiol 2016;26:436-443; Emerg Med J 2014;31:824-826; Acad Emerg Med 2014;21:122-129]

However, studies have also shown that some physicians lack sufficient knowledge about medical radiation, especially nonradiology doctors. [J Emerg Med 2014;47:36-44; J Med Imaging Radiat Oncol 2013;57:8-14; Emerg Med J 2012;29:306-308]

“With education, training and practical interventions to improve our current practice, shared decision-making can become the standard when imaging is considered in the PED,” the researchers said.