Editor's Commentary - Reviewing radiographic images with patients: Results of a trial on patient preferences, understanding, and satisfaction

BERKELEY, CA (UroToday.com) - Visual aids significantly improve patient/physician interactions.

These help patients better understand their diagnosis and tolerate invasive diagnostic maneuvers. Two separate prospective randomized studies have clearly delineated this important clinical phenomenon. Faiz Nasser and colleagues at the University of Arizona found that both showing radiographic images to patients and using a diagram to demonstrate their investigative findings during diagnostic and treatment counseling were equally effective in improving patient understanding of their condition and management options. Almost all patients on blinded satisfaction survey and a second unblinded survey reported comprehension of images, improvement in understanding because of review of images and actually preferred being shown radiographic images. These findings were significantly preferential for female patients. I personally have always routinely reviewed radiographic images with my patients and use a diagram to illustrate the findings that the patient then takes home. This study validates my clinical impression that this significantly helps in patient education and counseling.

Kashifuddin Soomro and colleagues, in a prospective randomized controlled study, also found that visualization of the endoscopic images during outpatient flexible cystoscopy significantly reduced patient perceived pain associated with the procedure. They used a visual pain analog scale for patient reporting of discomfort during flexible cystoscopy. They found that 95% of patients had no or mild pain if they were allowed to view their cystoscopy procedure; 2 patients reported moderate pain, while none of these patients reported severe pain. In contrast, only 47% of patients reported no or mild pain if they did not view their procedure and 13% in this group reported severe pain, while 39% had moderate pain. It is important for physicians to explain the disease process, options for management, and risks and benefits of each option with their patients during clinical encounters. The use of visual aids in the diagnostic and therapeutic management of urologic patients improves patient understanding and tolerance of their diagnostic studies and procedures.

Nasser FS, Ritsema DF, Cheney S, Stern K, Sokoloff MH, Hu CC, Nguyen MM


J Endourol. 2010 Dec;24(12):2083-91

PubMed Abstract
PMID: 20929431



Impact of patient's self-viewing of flexible cystoscopy on pain using a visual analog scale in a randomized controlled trial

Soomro KQ, Nasir AR, Ather MH

Urology. 2011 Jan;77(1):21-3.
doi: 10.1016/j.urology.2010.08.012


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