Finding Medical Photographs of Patients Online: Randomized, Cross-Sectional Study

Area of Science:

• Medical ethics
• Digital health
• Academic publishing

Background:

• Patient photographs from medical case reports are discoverable via online image searches.
• This indicates photographs circulate beyond journal websites, posing ethical and legal challenges.
• Previous studies have not systematically quantified this issue.

Purpose of the Study:

• To systematically evidence patient photographs from medical case reports appearing in Google Images.
• To determine the percentage of patient photographs found in search results.
• To investigate the link between open access status and image availability, and changes in third-party website appearances between 2020 and 2022.

Main Methods:

• A cross-sectional study analyzed a random sample of 585 case reports from PubMed.
• The primary outcome was the presence of at least one photograph in Google Images search results.
• Logistic regression and generalized estimating equations were used to analyze image source, third-party availability, and temporal trends.

Main Results:

• Over 76% of case reports with patient photographs had images discoverable on Google Images.
• Approximately 18% of images included facial or full-body views, with 10.9% potentially identifying patients.
• Image availability on third-party sites like ResearchGate and PubMed Central increased risk, though third-party appearances decreased from 2020 to 2022.

Conclusions:

• A significant proportion of medical photographs from case reports are accessible via Google Images, highlighting ethical concerns.
• Journal publishers and tech companies should collaborate on solutions.
• Enhanced patient consent processes are crucial, informing individuals about potential risks of image publication.