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Survey of physicians' attitudes about risks and benefits of chest computed tomography
J P Renston1, A F Connors, A F DiMarco
1MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
Insights
Physicians often order chest computed tomography (CT) scans, but many underestimate radiation risks and are uncertain about improved patient outcomes. Careful consideration of benefits versus risks is recommended before CT use.
Area of Science:
- Radiology
- Medical Imaging
- Diagnostic Procedures
Background:
- Computed tomography (CT) of the chest is widely used in medical practice.
- Physician attitudes towards the risks and benefits of chest CT are not fully understood.
Purpose of the Study:
- To investigate physicians' utilization patterns of chest CT.
- To assess physician perceptions of chest CT's risks, benefits, and impact on patient outcomes.
Main Methods:
- A nationwide survey of 1,000 board-certified physicians across various specialties.
- Self-administered mail questionnaire with 313 completed responses.
Main Results:
- Chest CT ordering practices varied significantly by medical specialty.
- Most physicians believed CT provided new information (64%) and influenced management (62%), but only 30% perceived improved patient outcomes.
- Over 90% of physicians underestimated or were unaware of the radiation dose associated with chest CT.
Conclusions:
- Physician knowledge regarding chest CT radiation risks appears inadequate.
- Given limited evidence from controlled trials, careful risk-benefit assessment is crucial before ordering chest CT.
- Further research is needed to establish clear indications for chest CT.
Abstract:
To investigate physicians' use of computed tomography (CT) of the chest and their attitudes regarding the risks and benefits of chest CT, we conducted a nationwide survey of 1,000 board certified physicians from several specialties of medicine, using a self-administered mail questionnaire. Three hundred thirteen surveys were completed. Overall, CT ordering practices varied with specialty. While the majority of physicians believed that CT provided new information (64%) and influenced patient management (62%), fewer physicians (30%) perceived that CT improved patient outcome. More than 90% of physicians either did not know or significantly underestimated the degree of radiation associated with CT (equivalent to 100 posteroanterior chest radiographs). We conclude that, given the paucity of prospective controlled trials establishing clear indications for the use of chest CT, physicians across all specialties should give careful consideration to the anticipated benefits and potential risks of chest CT before using this test.