Comment & Response |

Do Physicians Have an Obligation to Disclose the Uncertainty About Harms or Just the Harms?—Reply

Tanner J. Caverly, MD, MPH1,2; Allan V. Prochazka, MD, MSc1,2; Chad Stickrath, MD1,2
[+] Author Affiliations
1Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora
2Denver Veterans Affairs Medical Center, Denver, Colorado
JAMA Intern Med. 2013;173(18):1752. doi:10.1001/jamainternmed.2013.8462.
Text Size: A A A
Published online


In Reply We appreciate Dr Jha’s thoughtful response to our article.1 We agree that there is significant uncertainty and disagreement among experts about estimating the exact cancer risk associated with the ionizing radiation from computed tomographic (CT) imaging; informing patients about this uncertainty is a difficult task.

However, the case for an increased incidence of cancer among those exposed to the levels of radiation found in typical CT scans does not rely on modeling, as Jha suggests. Recent large-scale epidemiologic studies have quantified a small but seemingly real and dose-dependent cancer risk associated with CT scans among children and adolescents after only 10 years of follow-up.2,3 This evidence adds to earlier epidemiologic evidence that identified an increased incidence of cancer among atomic bomb survivors of all ages whose mean level of exposure to ionizing radiation was equivalent to 2 to 3 CT scans.4


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





October 14, 2013
Saurabh Jha, MD, MS
1Department of Radiology, Hospital of University of Pennsylvania, Philadelphia
JAMA Intern Med. 2013;173(18):1751-1752. doi:10.1001/jamainternmed.2013.8471.
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Related Topics