Evaluation of reliability of radiologic images posted on hospital websites for medical advertisements

Article information

J Korean Med Assoc. 2018;61(7):435-442
Publication date (electronic) : 2018 July 17
doi : https://doi.org/10.5124/jkma.2018.61.7.435
1Department of Radiology, Korea University College of Medicine, Seoul, Korea
2Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
Corresponding author: Bo-Kyung Je E-mail: radje@korea.ac.kr
Received 2018 June 15; Accepted 2018 June 29.

Abstract

Abstract

A medical advertisement can include media such as newspapers, magazines, and the Internet. Currently, the Internet is responsible for most medical advertising. Our purpose is to investigate the current status of radiologic images posted on hospitals’ websites nationwide, and to evaluate the reliability of online medical advertisements using these images. I investigated the websites of all 1,450 hospitals and 290 oriental medicine clinics nationwide. Specific information on the radiologic images posted was recorded. In terms of body parts, musculoskeletal images account for 78% of the radiologic images on hospitals’ websites and 98% of the images for oriental medicine clinics. The purposes for posting radiologic images are to explain the pathophysiology of diseases or the technique of surgical treatments, and to show the effects of hospital-specialized treatments. The most commonly used modalities of radiologic images are plain radiography and MR. More than 90% of the posted images have no source; 10% have no legends; and 5% to 7% have inappropriate legends. In terms of quality, only 60% of the radiologic images on hospitals’ websites are rated as acceptable. Fifteen percent of the oriental medicine clinics posted the radiologic images without having a medical doctor on staff. Considering the results, I conclude that it is necessary to reestablish a system of pre-screening and post-evaluation for reviewing hospital websites, especially focusing on the radiologic images posted. Then we can prevent the inappropriate information from influencing or damaging public health, and set up healthy medical competition.

Figure 1.

Frequency of modalities of radiologic examination posted on hospital's websites. MRI, magnetic resonance imaging; US, ultrasonography; CT, computed tomography.

Figure 2.

Frequency of modalities of radiologic examination posted on oriental medicine hospital's websites. MRI, magnetic resonance imaging; US, ultrasonography; CT, computed tomography.

Figure 3.

Examples to credit the source of radiologic images. (A) Imprinted name of the hospital, (B) watermarking name of the hospital, (C) described references of each images, and (D) exposed patient's name, age, and hospital number.

Figure 4.

Examples of images graded as poor quality. (A) It is impossible to define each vertebra on both images, due to inadequate contrast. (B) The resolution of lumbar spine MRI is very low. (C) The images are discolored and disproportional.

Figure 5.

Examples of incorrect explanation of radiologic images. (A) This section explains ankylosing spondylitis, but the images are spinal cord tumor. (B) This section compares the pre- and post-discectomy images, but the images are obviously from different patients. (C) This section explains the endoscopic surgery of spinal stenosis, but the images show post- laminectomy state. (D) The legends explain different methods of treatment, but the images are exactly the same.

Investigation of radiologic images posted on nationwide hospital's websites

References

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Article information Continued

Figure 1.

Frequency of modalities of radiologic examination posted on hospital's websites. MRI, magnetic resonance imaging; US, ultrasonography; CT, computed tomography.

Figure 2.

Frequency of modalities of radiologic examination posted on oriental medicine hospital's websites. MRI, magnetic resonance imaging; US, ultrasonography; CT, computed tomography.

Figure 3.

Examples to credit the source of radiologic images. (A) Imprinted name of the hospital, (B) watermarking name of the hospital, (C) described references of each images, and (D) exposed patient's name, age, and hospital number.

Figure 4.

Examples of images graded as poor quality. (A) It is impossible to define each vertebra on both images, due to inadequate contrast. (B) The resolution of lumbar spine MRI is very low. (C) The images are discolored and disproportional.

Figure 5.

Examples of incorrect explanation of radiologic images. (A) This section explains ankylosing spondylitis, but the images are spinal cord tumor. (B) This section compares the pre- and post-discectomy images, but the images are obviously from different patients. (C) This section explains the endoscopic surgery of spinal stenosis, but the images show post- laminectomy state. (D) The legends explain different methods of treatment, but the images are exactly the same.

Table 1.

Investigation of radiologic images posted on nationwide hospital's websites

Radiologic image Hospital Oriental medicine hospital
Explanation of disease Explanation of treatment Explanation of disease Explanation of treatment
Body part        
  Musculskeletal 260 (63.6) 300 (73.3) 42 (91.3) 24 (52.2)
  Non-musculskeletal 83 (20.3) 11 (2.7) - 1 (2.2)
Source of images        
  Crediting 41 (12.0) 33 (10.6) 1 (2.4) 1 (4.0)
  Non-crediting 302 (88.0) 278 (89.4) 41 (97.6) 24 (96.0)
Image quality        
  Acceptable 214 (62.4) 191 (61.4) 31 (73.8) 24 (96.0)
  Neutral 108 (31.5) 103 (33.1) 11 (26.2) 1 (4.0)
  Unacceptable 21 (6.1) 15 (4.8) - -
Figure legends        
  Yes 280 (81.6) 278 (89.4) 41 (97.6) 24 (96.0)
  Yes, but incorrect 21 22 2 2
  No 63 (18.4) 33 (10.6) 1 (2.4) 1 (4.0)

Values are presented as number (%).