Daramola Opeyemi O, Lidder Alcina K, Ramli Ramiza, Chandra Rakesh K, Shintani-Smith Stephanie, Conley David B, Kern Robert C, Tan Bruce K
Department of Otolaryngology-Head and Neck Surgery, Northwestern University-Feinberg School of Medicine, Chicago, Illinois, U.S.A.
Laryngoscope. 2015 Apr;125(4):791-5. doi: 10.1002/lary.24992. Epub 2014 Oct 24.
OBJECTIVES/HYPOTHESIS: The objective of this study was to report patients' knowledge and comfort level with computed tomography (CT) imaging for sinus disease and evaluate patient willingness to undergo empiric medical therapy (EMT) versus CT-directed therapy (CTDT).
Prospective survey study.
A 22-item survey was administered to patients with nasal/sinus symptoms in a tertiary care rhinology clinic. Questions elicited patient demographics, imaging history, and knowledge/comfort regarding imaging-related radiation exposure. Patients were presented with the theoretical choice of EMT versus CTDT, given the expected positive predictive value, in chronic rhinosinusitis (CRS) management.
Two hundred patients (52% female, age range 18-83 years) participated. Of these, 85% had symptoms for over 3 months. Only 91 patients (45.5%) were aware that CT imaging involved radiation exposure. Prior CT experience and past sinus surgery (P < .05), but not sex or education level, were associated with increased comfort with CT imaging. Most patients (78%) preferred CTDT over EMT. If a CT sinus was recommended, 77 patients (38.5%) had concerns, of which 26% identified radiation exposure as the leading concern. The majority (70%) were unsure about the relative radiation dose of a conventional CT.
Patients with CRS symptoms prefer CTDT over EMT if a diagnosis cannot be established definitively using exam findings. Although most patients deferred to the physician regarding the decision to utilize CT imaging, there is low awareness of CT-related radiation exposure, and a significant minority of patients have radiation-related concerns with regard to medical imaging for nasal and sinus symptoms.
目的/假设：本研究的目的是报告患者对鼻窦疾病计算机断层扫描（CT）成像的了解程度和舒适度，并评估患者接受经验性药物治疗（EMT）与CT引导治疗（CTDT）的意愿。
前瞻性调查研究。
对一家三级医疗鼻科诊所中出现鼻/鼻窦症状的患者进行了一项包含22个条目的调查。问题涉及患者的人口统计学信息、成像史以及对与成像相关的辐射暴露的了解/舒适度。在慢性鼻窦炎（CRS）管理中，根据预期的阳性预测值，向患者提供了EMT与CTDT的理论选择。
200名患者（52%为女性，年龄范围18 - 83岁）参与了研究。其中，85%的患者症状持续超过3个月。只有91名患者（45.5%）意识到CT成像涉及辐射暴露。既往CT检查经历和既往鼻窦手术（P < 0.05），而非性别或教育程度，与对CT成像更高的舒适度相关。大多数患者（78%）更喜欢CTDT而非EMT。如果建议进行鼻窦CT检查，77名患者（38.5%）存在顾虑，其中26%将辐射暴露视为主要顾虑。大多数（70%）患者不确定传统CT的相对辐射剂量。
如果仅通过检查结果无法明确诊断，患有CRS症状的患者更喜欢CTDT而非EMT。尽管在是否使用CT成像的决策上大多数患者听从医生的意见，但对CT相关辐射暴露的认知较低，并且有相当一部分患者对针对鼻和鼻窦症状的医学成像存在辐射相关顾虑。
