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Diagnostic CT Scans: Institutional Informed Consent Guidelines and Practices at Academic Medical Centers

¹ Department of Diagnostic Radiology, Yale University School of Medicine 333 Cedar Street, TE-2, New Haven, CT 06510.
² Department of Surgery, Division of Emergency Medicine, Yale University School of Medicine, New Haven, CT.
³ Also affiliated with Yale School of Management, Yale College Department of Economics, and Yale School of Public Health, New Haven, CT.

OBJECTIVE. The purpose of this article is to characterize current informed consent practices for diagnostic CT scans at U.S. academic medical centers.

MATERIALS AND METHODS. We surveyed 113 radiology chairpersons associated with U.S. academic medical centers using a survey approved by our institutional review board. The need for informed consent for this study was waived. Chairpersons were asked if their institutions have guidelines for nonemergent CT scans (by whom; oral and/or written), if patients are informed of the purpose of their scans (by whom), what specific risks are outlined (allergic reaction, radiation risk and dose, others; by whom), and if patients are informed of alternatives to CT.

RESULTS. The study response rate was 81% (91/113). Of the respondents, two thirds (60/90) currently have guidelines for informed consent regarding CT scans. Radiology technologists were most likely to inform patients about CT (38/60, 63%) and possible risks (52/91, 57%), whereas ordering physicians were most likely to inform patients about CT's purpose (37/66, 56%). Fifty-two percent (30/58) of sites provided verbal information and 5% (3/58) provided information in written form. Possible allergic reaction to dye was explained at 84% (76/91) of sites, and possible radiation risk was explained at 15% (14/91) of sites. Nine percent (8/88) of sites informed patients of alternatives to CT.

CONCLUSION. Radiology technologists are more likely to inform patients about CT and associated risks than their physician counterparts. Although most academic medical centers currently have guidelines for informed consent regarding CT, only a minority of institutions inform patients about possible radiation risks and alternatives to CT.

Keywords: cancer • CT • informed consent • radiation dose • radiation risk • radiology practice

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