Radiographs

This is a response I posted on an individual image question. I want to present it here as well:

Q: Ok so now that I've seen most of your images in this set, I have a question... to whom do photos taken during medical procedures belong? Does the patient get a say in what can be done with them?

A: In the US, the owner of the facility where the images were acquired owns the images. The patient has a right to have copies of any of any images obtained. I believe you are making a good point in that: Does the patient have the ability to restrict what usage will be had from the image? AFAIK, the patient can't restrict the usage of anonymized data for research and teaching purposes.

The problem is that achieving true anonymity is in flux. The current definition of "de-identified" data is such that said data can't be reasonably re-identified. The 18 parameters of HIPAA de-identification are:

(1) Names

(2) All geographic subdivisions smaller than a state, except
for the initial three digits of the zip code if the geographic unit formed by combining all zip codes with the same three initial digits contains more than 20,000 people.

(3) All elements of dates except year and all ages over 89

(4) Telephone numbers

(5) Fax numbers

(6) E-mail addresses

(7) Social security numbers

(8) Medical record numbers

(9) Health plan beneficiary numbers

(10) Account numbers

(11) Certificate or license numbers

(12) Vehicle identifiers and license plate numbers

(13) Device identifiers and serial numbers

(14) URLs

(15) IP addresses

(16) Biometric identifiers

(17) Full face photographic images and any comparable image

(18) Any other unique identifying number, characteristic, or code

These images meet the 18 identifier requirement. The argument could be made, however, that radiographs are a biometric identifier (# 16). Forensic pathologists use radiographs to make positive ID when they have a likely source of comparison. However, you must have a similar view to satisfy the points of ID to make a statistically probable match. That similar comparison in itself is a protected piece of information that can't be freely shared.

Of course, this is just compliance with the current law, and doesn't address the ethical implications. I would welcome discussion of that topic as well.
--------------------------------------- ------------------------

Most of these are JPEG images downconverted from the original 10Mb DICOM data. The older, film based images, were copied with a Sony DSC-V3. Presentation here is for use in teaching radiologic science.

Attribution is expected.

52 photos, 6 videos | 295,692 views

items are from between c.1994 & 09 Sep 2009.