Patient confidentiality and anonymity are of paramount importance.
Under no circumstances should any information, whether in the patient's presenting symptoms, case description, or images themselves, be uploaded that could identify an individual patient.
In short, nothing in your images or accompanying text should lead to the identification of an individual. The most easily overlooked is embedded data on your images, especially ultrasound. Ideally, your images should have no text on them whatsoever.
Our DICOM uploading process will automatically fully anonymise your cases before they are uploaded to Radiopaedia but will not remove "burnt-in" text (such as is often found in ultrasound or nuclear medicine studies). These will need cropping.
On this page:
Consent
Radiopaedia does not mandate patient consent to be obtained for all case contributions, provided that
patient confidentiality is maintained (see below), and
you abide by your local institution's policies
If in doubt, we urge you to err on the side of caution and obtain informed consent. You can download and return a Radiopaedia case upload consent form or use your local institution's consent form provided it clearly states the intended purpose and content of your submission. If you do obtain consent please send a copy to [email protected].
The following text needs to be added to the end of the case discussion:
Consent: Before this case was published, the patient and/or their guardian gave written informed consent. Radiopaedia stores this consent separately from this case. If you have any questions, please contact [email protected].
Permission ID: <to be provided>
What is considered an identifier
Identifiers are anything that could lead to the images being linked to a particular patient. Identifiers include (adapted from the HIPAA guidelines):
name
initials
date of birth
-
contact information, including
address, including full or partial postal code
telephone or fax numbers
e-mail addresses
unique identifying numbers, e.g. UR, MRN, HID
vehicle identifiers
medical device identifiers, e.g. serial numbers
Web or Internet protocol addresses containing any link to the patient
biometric data
facial photograph or comparable image; this includes photographs where facial details have been partially obscured (see below) 1
audiotapes
names of relatives
date of study
In addition please round off the patient's age to the nearest 5 years (for adults).
Sometimes anonymity cannot be guaranteed merely by removing the aforementioned information. The rarity of the condition, the circumstances of presentation, the demographics of the patient and the specifics of your practice may all contribute to potential identification. For example, a common condition may be almost unique if your practice services a small population.
Generally speaking, consent is required for clinical photographs of pediatric cases.
Rarely, there will be cases of sufficient educational value that publishing them with identifiers is in the public interest. This decision will be made by the editorial board at its absolute discretion and written consent will need to be obtained. Once approved, the case description should include a statement of consent, for example, "patient consent was obtained to publish this case”.
Facial recognition
Photographs
If clinical photographs are included, complete anonymity must be obtained.
Partial obscuration, for example, merely masking the eye region in a facial photograph is not considered adequate 1 as there are numerous other features still visible. Similarly mild pixelation is increasingly reversible by AI and thus it is not considered sufficient, unless very coarse and covering the entire face.
Cross-sectional imaging
Additionally, special considerations apply to cross-sectional imaging of the head and face. Uploading thin slices which include the facial soft tissues may, in some cases, jeopardize patient privacy. Therefore, thin sections of this region should only be used when clinically relevant, and preferably narrowed down to the region where the pathology of interest is.
If you upload images or text with identifiers
We at Radiopaedia.org are pretty easygoing, but when it comes to patient confidentiality issues we get really grumpy. The case will be deleted as soon as we become aware of it. No questions asked. If that was your only copy, we apologise, but you have been warned.
These issues are covered in our terms of use.
If you find identifying information
As Radiopaedia.org is a collaborative project, despite our best efforts we are unable to categorically prevent all identifying information being uploaded, and we rely on contributors to abide by our terms of use.
In the event that you were to find a case with personal information, we would be very appreciative of an email sent to [email protected] and we will remove the content immediately.
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