Most patients prefer reading their imaging results through a patient portal even if it means viewing them prior to talking with healthcare professionals, according to findings published March 20 in JAMA Network Open.
Researchers led by Brian Steitz, PhD, from Vanderbilt University Medical Center in Nashville also found that this trend goes for both normal and non-normal test results, whether they be imaging-related or not. However, they added that receiving a non-normal test results was tied to more worry among patients.
"As healthcare systems continue to navigate this new era of health information transparency, balancing patients' expectation of immediate access to their information with the need to manage increased worry and health care practitioner burden is increasingly important," Steitz and colleagues wrote.
Under the 21st Century Cures Act that took effect in April 2021, healthcare facilities are required to make all test results, medication lists, and clinical notes immediately available to patients and care partners upon their request. Patients can access these via an online patient portal.
However, some patients and clinicians prefer to talk about sensitive or abnormal results together, with previous pilot studies varying in patient preferences about how and when to receive results. For example, a study presented in 2021 showed that both patients and primary care physicians had increased understanding of their medical conditions following virtual visits with radiologists.
Steitz and co-authors wanted to better understand patient preferences and attitudes about receiving their test results online. They looked at survey data from 8,139 patients and care partners at academic medical centers in Tennessee, California, Colorado, and Texas. Imaging or biopsies accounted for 3,044 (48%) of 6,276 tests; the remainder included blood, COVID-19, genetic, or other tests.
Most survey respondents were female (63%) and spoke English as their primary language (94.5%). The median age was 64 years.
The researchers found that most respondents (95.7%) preferred to immediately receive test results through the patient portal. This includes (95.3%) of respondents who received non-normal results.
Also, 7.5% of respondents (411 of 5,473) reported that reviewing results before they were contacted by a healthcare practitioner increased worry. However, increased worry was more common among respondents who received abnormal results (16.5%) than those whose results were normal (5%).
Among respondents with non-normal imaging results, 146 of 833 (17.5%) reported more worry or much more worry compared with those with normal imaging results -- 104 of 1,791 (5.8%).
In a pooled model, the researchers also found a significant association between worry and non-normal test results, with an odds ratio (OR) of 2.71. However, they found no such ties between worry and precounseling (OR = 0.7).
The study authors suggested that based on their findings, providing patients with time to review, research, and process their test results could prepare them for discussions with healthcare professionals. They also called for future studies to explore better understanding of worry among patients receiving their results, which could lead to mitigation strategies.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)