Emergency department patient knowledge, opinions, and risk tolerance regarding computed tomography scan radiation

Computed tomography (CT) scanning use for emergency department (ED) patients has increased exponentially since its inception.

This study aimed to determine what patients view as the risk of radiation from CT scans, their risk tolerance and preference for alternative testing, and their opinions about informed consent and malpractice regarding CT scans.

A 25-question survey was administered to a random convenience sample of ED patients aged ≥ 18 years by trained research associates.

There were 487 patients approached to be surveyed; 78 patients were excluded, leaving 409 patients (84.0%) responding. Mean patient age was 40.5 (standard deviation [SD] 16.8) years, and 51.5% were female. Three hundred ninety of 409 (95.4%) believed doctors should explain the risks and benefits of CT, and 316/409 (77.3%) thought an informed consent form should be signed. One hundred seventy-nine of 409 (43.8%) patients recognized that there was more radiation from a CT scan than a single chest x-ray study. Three hundred twenty-four of 409 (79.2%) preferred CT angiography over lumbar puncture to exclude subarachnoid hemorrhage. To diagnose appendicitis, 199/409 (48.7%) preferred an ultrasound first even if it meant needing a subsequent confirmatory CT, and 193/409 (47.2%) preferred a CT right away. One hundred sixty-nine of 409 (41.3%) patients would still like to have a CT scan of the head after head trauma even if their physician did not believe the test was indicated.

This study elucidates patient preference and knowledge regarding CT scans. Overall, patients have a poor understanding of CT scan radiation, and desire to have risks explained to them as informed consent prior to the scan.