The number of incidental findings on medical imaging scans nearly quadrupled over nine years at a large academic medical center. That’s according to a new JACR analysis that fortunately offers strategies for following up on these unexpected imaging discoveries.
Incidental findings – defined as suspicious areas on medical images that aren’t related to a patient’s chief concern – comprise 15-30% of all medical imaging exams and are a growing challenge in radiology as imaging volume rises.
- Radiologists have a responsibility to include incidental findings in their reports, but who’s responsible for making sure patients know about them?
Healthcare providers have adopted different methods for incidental follow-up, ranging from workflow changes to medical IT solutions.
In the current study, researchers from Northwestern University describe the incidental follow-up system they developed, which worked as follows…
- An electronic button was embedded in the EMR for radiologists to click when an incidental finding was detected.
- This relayed a note to the nursing team, which ensured that the patient’s care provider (or the patient themselves) knew about the finding.
- The system required cases to be resolved when patients were notified of their findings and were told of the next steps to take.
In an analysis covering a total of 25.2k incidental findings from 2015 to 2023, researchers discovered…
- The number of findings grew at a compound annual growth rate of 21% with an average of 233 per month.
- Annual findings grew from 835 in 2015 to 4k in 2023 – a nearly 4X increase.
- 99% of findings were resolved.
- Cases had to be resolved within seven months of the finding’s discovery.
One caveat is that Northwestern considered the loop closed once the patient was notified of the finding, rather than whether the patient complied with the recommendation.
- A more robust protocol might involve additional longitudinal tracking to measure downstream effectiveness, which the authors note as a possibility for future research.
The Takeaway
The new study underscores the stunning growth of incidental findings in radiology. But it also offers hope to imaging facilities through implementation of a simple IT fix and workforce changes that go a long way toward keeping patients notified of their imaging results.
