Avoiding fears and promoting shared decision-making: How should physicians inform patients about radiation exposure from imaging tests?

PLoS One. 2017 Jul 7;12(7):e0180592. doi: 10.1371/journal.pone.0180592. eCollection 2017.


Objective: We aimed to evaluate the population's awareness about the radiation exposure associated with five specific imaging tests, and their preference regarding three different formats for receiving the information before undergoing an imaging test.

Methods: A quantitative and qualitative evaluation through a survey and focal groups including general population from two health departments in Spain. The sampling was carried out in stages (according to health department size) and stratified by age and sex, to get a representative sample. We randomly selected the participants from these stages to be contacted by telephone by a trained nurse. Oral informed consent was obtained.

Results: Of 602 participants in the quantitative survey, 418 (70.3%) stated that they were aware of the risk associated with radiation. While the majority of these 418 participants knew that x-rays involve radiation (85.4%), fewer were aware that CT (42%) and mammography (38%) also involve radiation, and a substantial proportion believed, incorrectly, that MRI (38%) and ultrasound (18.4%) expose patients to radiation. The population preference was to receive the information using both oral and written formats, accompanied by a table showing the equivalence of the radiation associated with the imaging test to either a number of chest X-rays and exposure number of days of background radiation.

Discussion: The general population does not receive enough information regarding radiation exposure and the associated risks related to imaging tests. Initiatives should be designed to reinforce the patient's awareness when ordering a diagnostic imaging test.

MeSH terms

  • Awareness
  • Decision Making*
  • Fear / psychology*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Physicians / psychology
  • Radiation Dosage
  • Radiation Exposure*
  • Risk Assessment
  • Spain
  • Tomography, X-Ray Computed

Grants and funding

This study has received funding by the Fondo de Investigaciones Sanitarias, Instituto de Salud Carlos III (Plan Nacional de I+D+I) PI13/01576 and co-funded by the Fondo Europeo de Desarrollo Regional (FEDER). Role of the Sponsors: Funders had no involvement in any aspect of the design of this study, preparation of results, or decision to submit for publication.