New research published in the Journal of the American College of Radiology suggests that patients place great importance in learning about their imaging results, even if the findings do not directly impact their healthcare. The knowledge obtained from these tests is viewed as “a valuable outcome.”
“Imaging tests are one of the most sophisticated types of diagnostic tools used in health care, yet there are concerns that imaging is overused,” wrote lead author Monica L. Zigman Suchsland, MPH, of the University of Washington in Seattle, and colleagues. “Currently, tests are typically evaluated and implemented based on their accuracy, and there is limited knowledge about the range of patient-centered outcomes (PCOs) that imaging tests may lead to.”
Suchsland and colleagues sought to assess patient experiences and outcomes of frequently used imaging tests such as x-ray, CT, MRI and ultrasound. The team recruited adult patients from four primary care clinics who had the aforementioned imaging tests in the 12 months preceding recruitment. A total of 45 patients, with an average age of 53 years, were used as the study cohort and underwent a single interview that described their imaging experience.
Of the patients, 30 underwent an imaging test for diagnostic reasons; 15 for screening or monitoring purposes. A total of 32 patients cited their provider as being the chief reason for having the test. Most of the patients did not have concerns related to their imaging test, though 11 patients had concerns regarding financial burdens or days lost from work.
“Overall, our results suggest that the full range of risks and benefits that patients perceive from imaging testing is more complex than ‘test accuracy’ alone,” Suchsland and colleagues wrote.
The four PCOs the researchers determined from interviews with various imaging modalities were: knowledge gained from the test, contribution to their overall healthcare journey, direct experiences during the test procedure and the impact of the testing process on patient emotions.
“The desire ‘to know’ or ‘find answers’ was raised by patients as the main motivation for the test,” the researchers wrote. “The knowledge obtained from imaging tests was seen as a valuable outcome.” Patients' desire to know results, even if they did not directly impact their care, was an unanticipated finding, the researchers noted.
The team also found that patients view imaging tests as being “routine” and an “overtly accepted component of their health care experience.” This finding may allude to the frequent use or overuse of imaging modalities within patients’ healthcare experiences. Or, the researchers noted, patients may want diagnostic certainty and access to “a higher level of care.” For example, access to a provider with more knowledge of the part of the body in question was critical to patients.
The team also noted that "previous imaging test experiences and encounters with medical staff influenced patients’ perceptions of the quality of care.”
In addition, the researchers observed that a “disconnect” exists between ongoing studies that assess imaging tests and what patients truly care about. Additional research into refining patient understanding regarding their diagnostic imaging tests should be a priority.
“In clinical practice, discussing with patients why a test is being ordered, what the other options are (including other tests, or not testing at all), and how the information gained will inform care can facilitate improvements in the decision-making process and set clearer expectations of imaging,” they concluded.