Is the diagnostic radiological image an underutilised resource? Exploring the literature

Medical Image sharing: What do the public see when reviewing radiographs? A pilot study

INTRODUCTION

Policymakers wish to extend access to medical records, including medical imaging. Appreciating how patients might review radiographs could be key to establishing future training needs for healthcare professionals and how image sharing could be integrated into practice.

METHOD

A pilot study in the UK using a survey was distributed to adult participants via the online research platform Prolific. All subjects were without prior professional healthcare experience. Participants reviewed ten radiographs (single projection only) and were asked a two-stage question. Firstly, if the radiograph was 'normal' or 'abnormal' and secondly, if they had answered 'abnormal', to identify the abnormality from a pre-determined list featuring generic terms for pathologies.

RESULTS

Fifty participants completed the survey. A mean of 65.8 % of participants were able to correctly identify if radiographs were normal or abnormal. Results in relation to the identification of a pathology were not as positive, but still notable with a mean of 46.4 % correctly identifying abnormalities. Qualitative data demonstrated that members of the public are enthralled with reviewing radiographs and intrigued to understand their performance in identifying abnormalities.

CONCLUSION

In the pilot, members of the public could identify if a radiograph is normal or abnormal to a reasonable standard. Further detailed interpretation of images requires supportive intervention. This pilot study suggests that patients can participate in image sharing as part of their care. Image sharing may be beneficial to the therapeutic relationship, aiding patient understanding and enhancing consultations between healthcare professional and patient. Further research is indicated.

What are the benefits and risks of sharing patients' diagnostic radiological images with them? A cross-sectional study of the perceptions of patients and clinicians in the UK

OBJECTIVES

The objective for this work was to assess clinical experts' and patients' opinions on the benefits and risks of sharing patients' diagnostic radiological images with them.

SETTING

This study was conducted outside of the primary and secondary care settings. Clinical experts were recruited at a UK national imaging and oncology conference, and patients were recruited via social media.

PARTICIPANTS

121 clinical experts and 282 patients completed the study. A further 73 patient and 10 clinical expert responses were discounted due to item non-response. Individuals were required to be a minimum of 18 years of age at the time of participation.

PRIMARY AND SECONDARY OUTCOME MEASURES

This study was exploratory in nature. As such, the outcomes to be measured for demonstration of the successful completion of this study were generated organically through the process of the investigation itself. These were: (1) the delineation of the benefits available from, and the risks posed by, widening access to diagnostic radiological images; (2) establishment of the level and nature of demand for access to diagnostic radiological images; and (3) the identification of stakeholder requirements for accessing available benefit from diagnostic radiological images.

RESULTS

403 usable questionnaires were returned consisting of responses from clinical experts (n=121) and patients (n=282). Both groups acknowledge the potential benefits of this practice. Examples included facilitating communication, promoting patient engagement and supporting patients in accepting health information shared with them. However, both groups also recognised risks associated with image sharing, such as the potential for patients to be upset or confused by their images.

CONCLUSIONS

There is a demand from patients for access to their diagnostic radiological images alongside acknowledgement from clinical experts that there may be benefits available from this. However, due to the acknowledged risks, there is also a need to carefully manage this interaction.

TRIAL REGISTRATION NUMBER

187752.