Follow-up care improves with reporting template for incidental findings
Standardized templates that communicate incidental findings increase the likelihood that a patient will undergo further evaluations, according to a new report published in the Journal of the American College of Radiology.
The paper focused specifically on incidental adrenal masses (IAM) detected on imaging performed for clinically unrelated reasons. During the trial period, when radiologists utilized a standardized reporting template to communicate the findings with referrers, there was an increase in the number of patients who followed up with their primary care providers (53.7% vs. 36.3%) to discuss the findings in comparison to when findings were not relayed via the template.
Even after adjusting for sex, current and/or prior malignancy and the provider ordering the initial imaging (ER, PCP, specialist, etc.), use of the template resulted in 2.0 times higher odds of patients undergoing further evaluation.
Corresponding author Alison Woods, MD, of tBoston University School of Medicine and colleagues explained that this finding is important because although up to 25% of IAMs are found to be disease-causing lesions, they are rarely evaluated after incidental detection.
“There is a clear need for process improvement in the management of incidental radiographic findings of the adrenal glands and other organs,” the authors suggested.
Use of the template, which included PCP notifications, also resulted in an increase of biochemical testing, follow-up imaging and specialist referrals in patients with IAMs (35.2% vs. 18.5%, 40.7% vs. 23.3%, 22.2% vs. 4.8%) in comparison to when it was not utilized.
However, despite radiologists being aware of the template’s availability, it was only used in 27% of cases that involved IAMs. It was, however, viewed as a useful tool by 91% of the radiologists surveyed. These figures, the authors suggested, could represent an opportunity to improve the template’s implementation.
“If radiologists view the intervention as acceptable, refining implementation may lead to better outcomes,” the experts explained. “Other implementation strategies could include periodic audit and feedback for individual radiologists, reporting benchmarks set by high-adopters, or financial incentives.”
If their single center results are able to be replicated, the authors suggested that future work should focus on ways to better facilitate utilization of standardized templates by radiologists.
The study abstract is available here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.