433 AJR I 993;161 :433-436 0361 -803X/93/1 61 2-0433 © American Roentgen Ray Society Perspective How Should Radiologists Reply When Patients Ask About Their Diagnoses? A Survey of Radiologists’ and Clinicians’ Preferences David B. Levitsky,1 Mark S. Frank,1 Michael L. Richardson,1 and Robert J. Shneidman2 Radiologists must consider several factors when asked by a patient to disclose the results of a radiologic examination. This study represents a survey of radiologists’ and clinicians’ opin- ions regarding disclosure of information to patients by the radiologist. A clearer understanding of the preferences of radi- ologists and clinicians may serve to improve communication and enhance cooperation between the two groups, with the ultimate result being improved patient care. Patients often ask radiologists about the results of their radiologic examination. The decision to share results with the patient depends on the radiologist’s personal guidelines and his or hen perception of the expectations and nights of both the referring clinician and the patient. Although many clinicians and radiologists (and patients) hold strong opin- ions, no systematic investigation of this complex issue has been reported in this country. Because the results of a sun- vey concerning how much information radiologists should share with patients if patients ask for information might bet- ten assess current preferences of clinicians and radiologists and lead to improved cooperation between the two groups, we conducted a survey of clinicians in the Pacific Northwest and of radiologists in many parts of the country. Materials and Methods A survey questionnaire with a seven-point Likert scale was dis- tnibuted to 390 board-certified radiologists. Of these, 165 were Seat- tie-area radiologists employed by health maintenance organizations (HMOs), teaching hospitals, and private practices. The other 225 questionnaires were distributed by mail to radiology departments at university hospitals in Georgia, Iowa, Minnesota, New Mexico, Pennsylvania, South Carolina, and Texas. These departments were chosen in an attempt to achieve a sampling of different geographic regions across the United States. A self-addressed stamped enve- lope was attached to each questionnaire, along with a cover letter explaining the survey. We received 188 responses (1 03 responses from local radiologists and 85 from other regions). No responses were received postmarked from Pennsylvania; we assume this packet of 25 questionnaires was lost in the mail. The response rate for radiologists was 52% (188 responses out of 365 questionnaires). The same questionnaire was distributed to 532 clinicians, of whom 127 were members of the University of Washington hospital system, including the departments of internal medicine, surgery, family practice, obstetrics, and pediatrics. The remaining 405 ques- tionnaines were distributed to all practicing clinicians at the Kaiser Permanente HMO in Portland, OR. The response rate for clinicians was 47% (248 responses, with 60 from local clinicians and 1 88 from Kaiser Penmanente). The questionnaire asked respondents to rate their willingness to have a radiologist, if asked by the patient, disclose the results of an examination to the patient, both for a study with normal results and for a series of 11 specific radiologic findings (Table 1). These find- ings were chosen to provide an assortment of four mild, three mod- enate, and four severe abnormalities. To test our subjective classification, we gave 20 physicians (10 radiologists and 10 clini- cians) a list of these 11 entities and asked them to rank the abnor- malities as mild, moderate, or severe. All entities that we initially classified as mild abnormalities were ranked as mild by 95-100% of Received September 29, 1 992; accepted after revision March 4, 1993. 1 Department of Radiology, University of Washington, 1 959 N.E. Pacific Ave., Seattle, WA 981 95. Address correspondence to D. B. Levitsky. 2Department of Gastroenterology, Oregon Health Sciences University, Portland, OR 97201. Downloaded from www.ajronline.org by 52.73.204.196 on 05/17/22 from IP address 52.73.204.196. Copyright ARRS. For personal use only; all rights reserved