Radiologists are more accurate, confident when they know the full story
Radiologists are better at their jobs when they have a full report of the patient's symptoms, according to a recent study published in Radiology.[1]
In their findings, researchers from the department of radiology at Massachusetts General Hospital noted that MRI images are able to clearly show nearly all degenerative and structural issues of the spine. However, in some cases an abnormality may have no connection to a patient’s symptoms, such as pain or limited mobility. Because the same abnormalities can occur in both symptomatic and asymptomatic individuals, an MRI scan alone may not be sufficient to identify the true cause of a patient’s symptoms.
“MRI exams of the lumbar spine often show many degenerative abnormalities. Most of these are incidental findings that do not cause pain,” co-author William E. Palmer, MD, division chief of musculoskeletal radiology with Massachusetts General Hospital, said in a statement. “To diagnose the true pain generators and make the best treatment decisions, symptoms must be matched with MRI abnormalities.”
Palmer and his team sought to better understand how patient-reported symptoms improved the accuracy of MRI readings and subsequent diagnosis. Between May 2022 and February 2023, a cohort of 240 patients at Massachusetts General Hospital filled out a short questionnaires prior to a lumbar spine MRI. The questionnaire detailed their symptoms, specifically where pain was located and what factors exacerbate it.
MRI images were then reviewed by musculoskeletal radiologists, who alternated recording their findings with and without knowledge of the questionnaires. These diagnoses were also compared to doctors who specialize in spinal care, who based their diagnosis only on a face-to-face interview with patients.
All of the clinicians in the study rated the confidence they had in their diagnosis on a scale of 0 to 100.
When reviewing the results, the researchers found the radiologists who read MRI images with patient questionnaires attached were in nearly perfect statistical agreement with the spinal specialists when it came to making a diagnosis.
Confidence levels dropped significantly for only the readings from radiologists who did not know details on patient-reported symptoms.
“We have shown that patient-reported symptom information can improve interpretative performance. Symptom information in this study came from a pre-MRI questionnaire used in routine daily practice. With questionnaire results, radiologists agreed almost perfectly with the types, levels, and sides of pain generators diagnosed by spine specialists,” the study's authors wrote.
Palmer et al. added that additional studies are necessary to see if this improvement in diagnosis results in improved outcomes for patients.
The full study can be found at the link below.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.