Factors Affecting Adherence to Recommendations for Additional Imaging of Incidental Findings in Radiology Reports |
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| Affiliation: | 1. Department of Radiology, University of California, Davis Medical Center, Sacramento, California;2. Associate Chair of Informatics, Department of Radiology, University of California, Davis Medical Center, Sacramento, California;3. Department of Public Health Sciences, University of California, Davis, California;4. Director of Body MRI, Department of Radiology, University of California, Davis Medical Center, Sacramento, California;1. Department of Radiology, The Edward Via College of Osteopathic Medicine, Spartanburg, South Carolina;2. Department of Radiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York;3. Department of Radiology, AdventHealth Orlando, Orlando, Florida;4. Department of Radiology, Liberty Hospital, University of Missouri–Kansas City School of Medicine, St. Louis, Missouri;5. Department of Radiology, Mount Auburn Hospital, Cambridge, Massachusetts;1. Center for Ethics, Emory University, Atlanta, Georgia;2. Director of the Institutional Review Board, Emory University, Atlanta, Georgia;3. Vice Chair of Health Policy and Practice, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia;4. Vice Chair for Imaging Infomatics, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia;5. Department of Computational Mathematics, Science and Engineering, Department of Biomedical Engineering and Radiology, Michigan State University, East Lansing, Michigan;1. Department of Radiology, NYU Grossman School of Medicine, New York, New York;2. Department of Population Health, NYU Grossman School of Medicine, New York, New York;3. Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan;4. Department of Obstetrics & Gynecology, University of Michigan Health System, Ann Arbor, Michigan;1. Montefiore Medical Center & Albert Einstein College of Medicine, Bronx, New York;2. Assistant Professor of Pediatrics, Director of the Pediatric Sickle Cell Program, Director of the Pediatric Hematology Oncology Fellowship Program, Division of Pediatric Hematology/Oncology and Cellular Therapy, The Children’s Hospital at Montefiore and Montefiore Medical Center, Bronx, New York;3. Soroka University Medical Center, Beer Sheva, Israel;4. Ben-Gurion University, Beer Sheva, Israel;5. Director of Outpatient Imaging, Montefiore Medical Center; Director, Division of Pediatric Radiology; Associate Program Director, Diagnostic Radiology Residency; Associate Professor of Radiology Departments of Radiology and Pediatrics, Montefiore Medical Center and The Children’s Hospital at Montefiore Albert Einstein College of Medicine Bronx, New York;1. Joint Department of Medical Imaging, University Health Network–Mount Sinai Hospital–Women’s College Hospital, University of Toronto, Toronto, Ontario, Canada;2. Department of Cytopathology, University Health Network, University of Toronto, Toronto, Ontario, Canada |
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| Abstract: | ObjectiveTo determine the rate at which recommendations for additional imaging (RAIs) of incidental findings on CT are adhered to at a tertiary-care medical center and what factors influence adherence.MethodsWe used a radiology clinical informatics tool (mPower, Nuance Communications Inc, Burlington, Massachusetts) to identify RAIs in reports from all CT examinations performed at a tertiary-care medical center during a 6-month period. For those studies in which the RAI was for incidental findings, we reviewed the patients’ charts to determine if there was appropriate follow-up of the lesion in question.ResultsThe overall rate of adherence to RAIs was 39.1%, and in patients with a same-institution primary care provider (PCP), 56.8% (P < .0001). Adherence was higher in studies ordered in the outpatient setting (P < .0001) and in patients with a same-institution PCP (P < .0001). Among patients with a same-institution PCP, adherence was highest for outpatients (66.7%), followed by patients seen in the emergency department (46.0%) and inpatients (36.0%). Among outpatients, adherence was highest with PCPs (67%) followed by internal medicine subspecialties (50%) and surgery (38%).DiscussionThe rate of adherence to recommendations for additional imaging of incidental findings was 39.1% in this study and higher for patients with a same-institution PCP, studies ordered in the outpatient setting, and in studies ordered by PCPs. |
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| Keywords: | Adherence follow-up incidental recommendations |
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