Communicating results of diagnostic mammography: what do patients think?

RATIONALE AND OBJECTIVES: The purpose of this study was to investigate women's preferences for who (radiologist or referring physician) should communicate the results of diagnostic mammography. MATERIALS AND METHODS: Data from 153 women presenting to two sites for diagnostic mammography between February and June 1995 were collected with a 24-item, self-administered, closed-ended survey. For both normal and abnormal hypothetical results, contingency tables with chi2 tests and multiple logistic regression were used to determine the association, if any, between women's characteristics and their preferences. RESULTS: Women undergoing diagnostic mammography preferred that their radiologists disclose their normal (90%) and abnormal (88%) mammogram results to them immediately after their examination, rather than have their referring physicians disclose results at a later time. In the case of normal findings, women whose regular physicians were specialists were less likely to want to hear first from their radiologists (odds ratio [OR] = 0.06; 95% confidence interval [CI] = 0.01, 0.77; P = .03), but women who were nervous about learning their results were more likely to want to hear first from their radiologists (OR = 4.5; 95% CI = 1.2, 17.3; P = .03). CONCLUSION: Radiologists may want to consider assessing women's preferences for who communicates their mammogram results, as most women in this study preferred to hear these results from their radiologists rather than waiting to hear from their referring physicians.     

Radiological journals in the online world: should we think Open?

The scientific community is becoming increasingly web-based and the role of online communication is continuously expanding. In this setting, one fact and two trends should be considered. The fact is the decision by Britain’s government and by the European Union to make all papers deriving from projects that were paid for using public funds freely available online for reading and redistribution (an approach already widely used in the US). The trends are the ‘open review’ process and the future perspective of having online-only scientific journals; the balance of advantages and disadvantages of such an approach is debated. These factors are challenging the scientific community worldwide and radiological scientific societies should play a relevant role in driving these processes. Key Points: ? Research funded by the EU and Britain’s government will soon be freely available ? The open-review process has started in certain scientific communities, but not yet within radiology ? Online communication is increasing its power within the scientific community     

What do under 15 year old schoolboy rugby union players think about protective headgear?

OBJECTIVES: When protective headgear is designed, the attitudes of the intended users needs to be taken into account, as well as safety performance criteria. The aim of this study was therefore to determine the attitudes of schoolboy rugby union players towards protective headgear. METHODS: A survey of 140 rugby union players (82.4% response rate) from 10 randomly selected school teams in metropolitan Sydney was conducted at the end of the 1999 playing season. All players were aged 14-16 years. All teams had participated in a trial of headgear during the 1999 season in which six of the teams had been assigned to a headgear trial arm and four teams to a control arm. Players completed a self report questionnaire during a supervised session at school. The questionnaire collected information on recent head injuries, use of protective equipment, and attitudes towards headgear. RESULTS: Some form of protective equipment was always worn by 76.1% of players: 93.6% reported using a mouthguard and 79.3% a helmet/headgear during the 1999 season. The two most important reasons for wearing headgear were related to safety concerns. Players with no recent head/neck injury were more likely to report that they felt safer when wearing headgear (p<0.001) and less likely to cite a previous injury as a motivating factor for wearing headgear (p<0.001) than those who had sustained a recent head/neck injury. Of the players who wore headgear during the 1999 season, 67% said that they played more confidently when they wore headgear, but 63% said that their head was hotter. Few players reported that their head was uncomfortable (15%) or that it was hard to communicate (3%) when they wore headgear. The main reasons for not wearing headgear were related to its design features: uncomfortable (61%) and it was hot (57%). CONCLUSIONS: The primary reason cited by players for wearing headgear is safety. Receiving an injury would also motivate non-wearers to wear headgear. Players report that they are more confident and able to tackle harder if they wear headgear, suggesting that a belief in its protective capabilities may influence behaviour. These attitudes need to be addressed in the design of effective headgear as well as in strategies to promote its use.     

Clinical effectiveness: how much do radiographers know about it and what do they think of the concept?

Purpose: The dual concepts of evidence-based practice (EBP) and clinical effectiveness have become ever more important in the health service in recent years. In order that suitable initiatives can be derived and future policy shaped and evaluated it is important that the current level of knowledge and attitudes towards the concepts are recorded. The current study aimed to examine these in a representative sample of radiographers.Methods: A total of 138 individual radiographers selected at random from the population of radiographers within Wales were approached and requested to complete a postal questionnaire. Of those approached, 76 completed and returned the questionnaire.Results: Individuals considered themselves to be lacking in certain key skills essential for evidence-based practice. Specifically, these appeared to be related to the more ‘technical’ research-related skills and there was limited evidence that individuals were undertaking many of these components. However, attitudes towards EBP and clinical effectiveness were, by and large, positive.Conclusion: The current underlying culture provides a firm foundation for the necessary education and encouragement required for the fuller implementation of evidence based practice in radiographers.     

Benefit-risk communication in paediatric imaging: What do referring physicians,radiographers and radiologists think,say and do?

IntroductionTo assess how referrers and practitioners disclose benefit-risk information about medical imaging examinations to paediatric patients and their parents/guardians; to gauge their confidence in doing so; and to seek their opinion about who is responsible for disclosing such information.MethodsThis study followed on from a previously published study, with a questionnaire distributed in staggered phases to 146 radiographers, 22 radiology practitioners, 55 emergency physicians and 43 paediatricians at a primary paediatric referral centre in Malta. The questionnaire sought details about referrers' and practitioners' practice of disclosing benefit-risk information, as well as their opinion about their confidence and responsibility to do so.ResultsAn overall response rate of 63.2% (168/266) was achieved. Most referrers and practitioners would generally explain the purpose of the imaging examination, with fewer providing benefit-risk information. The content and the approach adopted to communicate benefit-risk information varied, at times considerably. While 75% (123/164) felt that the responsibility to provide benefit-risk information was a shared one between referrers and practitioners, only 32.1% (53/165) reported a high level of confidence in their own ability to do so.ConclusionsOur findings highlight potential knowledge and skills gaps amongst local referrers and practitioners. This needs addressing so as to ensure that paediatric patients and their parents/guardians are provided with adequate, reassuring and consistent information. Additionally, we recommend that local referrers and practitioners come together and develop a consensus document that can offer guidance on how to go about discussing the benefits and risks of paediatric imaging examinations.