Patients poorly understand common terms in imaging reports, potentially leading to low-value care

Healthcare consumers often do not understand common terms in lumbar spine imaging reports, possibly contributing to patient pain and anxiety, according to new survey data shared Monday.

Lower back discomfort frequently propels individuals to seek treatment, often leading to imaging exams that unearth nonspecific findings. Unable to understand their results, patients may seek further frivolous testing or unnecessary treatment, experts detailed in BMJ Open.

Surveying hundreds of patients across five English-speaking countries, researchers found a clear need to simplify spine write-ups to help reduce the delivery of low-value care.

“The radiology report may play a role in mediating the relationship between imaging and overtreatment in [lower back pain] and providing contextual information has been reported to reduce unnecessary repeat imaging, opioid prescription and specialist referral,” Caitlin Farmer, with the Department of Musculoskeletal Health and Clinical Epidemiology at Cabrini Health in Malvern, Australia, and co-authors wrote Sept. 13. “Our study provides evidence that commonly identified and reported terms in radiology reports are also associated with misplaced patient concerns about their implications, which may also influence their healthcare decision making,” they added later.

Farmer et al. conducted their online survey last year, garnering 774 responses across the U.K., U.S., Canada, New Zealand and Australia. Of those, 85% (577) had a history of back pain and 44% (251) previously received spine imaging. Respondents were quizzed around their understanding of 14 terms, including annular fissure, disc bulge, facet joint degeneration and nerve root contact.

The survey found “poor” overall comprehension of such terms, with “disc generation” the most well-understood (35%) and “modic changes” the least (10.5%). Despite denoting non-severe ailments, the majority of respondents though these terms indicated a serious back issue (59%-71%), pain that would likely persist (52%-71%), or posed potential impediment to their movement (42%-57%).

Farmer and co-authors from institutions including the University of Washington, Seattle, believe their findings could apply to other musculoskeletal concerns, such as cervical spine disc bulges, meniscal knee tears and shoulder tendinosis.

“There is now both imperative and empirical data indicating the importance of accurately and clearly portraying the significance of imaging findings in terms that are understandable to both clinicians and patients,” the authors advised. “Incorporating clear explanations about the implications of these findings may reduce unwarranted anxiety and reduce low-value care,” they added later.

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