Managing incidental radiologic findings: ACR-led initiative proposes several recommendations

An ACR-led initiative recently tackled the issue of poor completion rates for radiologist recommended follow-up care after incidental findings are identified. The proposed measures were recently published in the Journal of the American College of Radiology.

“Care gaps occur when radiology follow-up recommendations are poorly communicated or not completed, resulting in missed or delayed diagnosis potentially leading to worse patient outcomes,” corresponding author Nadja Kadom, MD, Director, Radiology Quality, Department of Radiology, with Children’s Healthcare of Atlanta, and co-authors wrote.

To address the issue at hand a technical expert panel (TEP) was assembled to advise quality measures that would improve communication between providers and patients and thus increase completion rates for follow-up care. The measures are meant to serve as a guideline for practices to create their own communication systems and means of follow-up improvement after noncritical actionable incidental findings are identified by radiologists. 

The foundation of the ACR-led initiative is based on nine measures—four pertaining to outcomes and five relative to processes.  

Suggested outcome measures include requiring closing the communication loop upon completion of follow-up recommendations for actionable incidental findings (AIFs), with specific guidance pertaining to findings of abdominal aortic aneurysm and pulmonary nodules, in addition to follow-up imaging and surveillance recommendations in the instances of cancer detection. For each of these measures, successful follow-up was defined as having recommended imaging completed within 30 days before and 60 days after the suggested follow-up interval. 

“This measure serves the initiative’s primary goal, evaluating the percentage of patients with at least one AIF who received follow-up imaging within the recommended time interval,” the authors explained.