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Quantifying Worry in the Face of Uncertainty: Radiation Exposure from Medical Imaging
Michael Coppolino1, Andrew L Avins2, Andrew Callen3
1Department of Critical Care Medicine, Kaiser Permanente San Francisco Medical Center, San Francisco, California, USA.
Background:
The degree to which people worry about radiation exposure from medical imaging has not been quantified. Such concern is important for clinical decision making and policy generation.
Objective:
The aim of this study was to quantify the degree of worry as a consequence of radiation exposure.
Design:
A time trade-off methodology was used to estimate health state utilities associated with radiation exposure from computed tomography scans in an inclusive sample of physicians. Health state utilities were elicited from in-person interviews using a software-guided, hypothetical scenario in which the subject is exposed to two separate computed tomography scans.
Results:
One hundred and eighteen interviews were conducted. The overall mean and median utility values for the health state of concern due to radiation exposure were 0.95 (95% confidence interval: 0.94-0.96) and 0.98 (interquartile range: 0.91-1.00), respectively. The utility score distribution was highly skewed toward higher values. Five respondents (4.3%) recorded a utility score of ≤0.8 and 17 respondents (14.5%) were willing to sacrifice at least 5 or more years of life to live free of the radiation-exposure worry.
Conclusions And Relevance:
The physician respondents generally demonstrated low levels of disutility; however, a subset of physicians expressed much greater disutility for the future risk of malignancy. Given the potential for physicians to influence health care decisions and policies, further study of radiation-related concerns seems warranted. Physicians, patients, and the general public should be aware of the potential impact such differing views held by physicians may have on their clinical recommendations.
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