Patient Photos Spur Radiologist Empathy And Eye For Detail

"Our study emphasizes approaching the patient as a human being and not as an anonymous case study," said lead author Yehonatan N. Turner, M.D., radiology resident at Shaare Zedek Medical Center in Jerusalem, Israel.

Many radiologists have limited contact with patients. A referring physician will order imaging exams, such as MRI or computed tomography (CT), and the radiologist interprets the results, never having met the patient.

Technological advances have further distanced the radiologist from interaction with the patient. With the advent of teleradiology, radiologists are now able to view images from remote locations via the Internet or satellite.

"We feel it is important to counteract the anonymity that is common in radiologic exams, especially with the growth of teleradiology," Dr. Turner said.

The researchers set out to determine if the addition of a patient's photograph to the file would affect how radiologists interpreted the results.

For the study, 318 patients referred for CT agreed to be photographed prior to the exam. The images of the patients were added to their files in the hospital's picture archiving and communication system (PACS), a network for storage and retrieval of medical images. The photograph appeared automatically when a patient's file was opened.

After interpreting the results of the exams, 15 radiologists were given questionnaires to gather data about their experience. All 15 radiologists admitted feeling more empathy towards the patients after viewing their photos. In addition, the photographs revealed medical information such as suffering or physical signs of disease.

More importantly, the results showed that radiologists provided a more meticulous reading of medical image results when a photo of the patient accompanied the file.

Incidental findings are unexpected abnormalities found on an image that may have health implications beyond the scope of the original exam. In order to assess the effect of the photographs on interpretation, 81 examinations with incidental findings were shown in a blinded fashion to the same radiologists three months later but without the photos. Approximately 80 percent of the radiologic incidental findings reported originally were not reported when the photograph was omitted from the file.

The radiologists involved in the study commented that while the addition of the photo did not lengthen the time spent reading, it was a factor in how meticulously they interpreted the images. All 15 radiologists agreed that the inclusion of a photograph in a patient's file should be adopted into routine practice. The photos can also be included in long-distance teleradiology practices.

"The photos were very helpful both in terms of improving diagnosis and the physicians' own feelings as caregivers," Dr. Turner said. "Down the road, we would like to see photos added to all radiology case files."

Co-authors are Irith Hadas-Halpern, M.D., and David Raveh, M.D.