RFS news highlights resources, issues, and news relevant to in-training members of the ACR. If you have a topic idea or would like to contribute to the blog, please email RFS Secretary Nathan Coleman, MD.
Navigating Patients Through the Internet of Misdirection
The importance of providing patients with peer-reviewed material in the information age
“My doctor ordered a CT scan, but I am worried about the effects of radiation. You’re a radiologist, what are your thoughts?” Substitute ‘CT scan’ in the preceding sentence with most radiology studies and a familiar question surfaces.
As the holiday season approaches, expect your aunt Minnie to present this loaded question as you masticate a side of mashed potatoes and gravy. Prior to a STAT consult for Dr. Google, question whether Google’s medical degree will direct your dear aunt to the reliable, peer-reviewed content needed in this situation.
Recently in JACR’s October issue, a cohort from Cork University in Ireland chartered an investigation to assess the quality of medical information pertaining to CT radiation dose. Using Google, the team simulated common search scenarios. The team disclosed no conflicts of interest. Two senior authors validated content accuracy and measured content against standards published by the ACR and European Congress of Radiology. The results gathered were concerning.
The group reported 1,400 website results using the 14 search phrases. The first 100 websites per search were included. About 20 percent (n=290) of sites were judged relevant and accessible without a discreet user login. Stratification of these results into three subgroups included: completely accurate, somewhat accurate, and inaccurate. From 290 sites, 13 percent (n=37) were inaccurate. Interestingly, the team reported that prevalence of inaccurate sites increased with broader search terms, and discussion forums showed the highest percentage of inaccurate content overall. Peer-reviewed journals accounted for 18 percent of results with the highest percentage of accurate information.
Limitations in methodology are clearly exposed by the team. Notably, the first 100 results for each search-phrase were included. Non-English websites were excluded. Notably, a single search engine limited to the first 100 hits using one language. The search terms did not originate from actual patients and therefore, were not fully representative. Websites published in English constituted the primary assessed language, presumably due to the content reviewers’ comfort with this language1.
The perception of medical information directly influences patients, and ultimately guides their decision-making with respect to healthcare utilization. Today, most seek additional information on the Internet. This craving for knowledge in times of uncertainty should be encouraged. The Internet is potent - effortlessly corroborating fears with unsubstantiated information. Our responsibility to do no harm extends outside the brick-and-mortar office. Providing patients with peer-reviewed material in the information age is a requisite.
As the holidays approach, remain conscious of your role in healthcare while gobbling hot turkey and bread stuffing. While away from the workstation, we can continue to assist patients, especially as they navigate the Internet seeking more knowledge. If posed a question you feel less confident to answer, direct them to a site published by both the ACR and RSNA, www.radiologyinfo.org. They also publish information in Spanish too. Happy Holidays!
By Michael Chorney, MD, diagnostic radiology resident at Pennsylvania Hospital of the University of Pennsylvania Health System.
1O’Neill, S, Glynn, D, Murphy, KP, et al. An Assessment of the Quality of CT Radiation Dose Information on the Internet. J Am Coll Radiol. In press.