Doctors decide to use CT scans, but with little talk of risks

Tanner J. Caverly, M.D., from the University of Colorado Anschutz Medical Campus in Aurora, and colleagues surveyed 286 consecutive patients undergoing outpatient CT at the Denver Veterans Affairs Medical Center from November through December 2011. The questionnaire addressed four domains: (1) demographics, (2) presence of risk communication, (3) preference for more information, and (4) knowledge of potential harms.

The researchers found that, of the 271 respondents, 86 percent were older than 50 years; 92 percent were male; 27 percent had a high school education or less; and 92 percent had had at least one previous scan, with 38 percent reporting more than five previous scans. A majority believed that it was mainly the physician's decision to undergo CT (62 percent). Roughly one-third (35 percent) said they discussed the potential risks of the test with their health care provider, and a similar number (37 percent) knew that CT was associated with more radiation than chest radiography. Prior to having the CT scan, only 46 respondents (17 percent) reported all of the following prior: having a shared final decision, discussing the potential benefits, and discussing the potential risks with their health care provider.

"Our study indicates that most decisions to undergo outpatient CT are made by physicians and risk communication is infrequent," the authors write.

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Journal reference: JAMA Internal Medicine

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