A large team of Texas radiologists is utilizing a new reporting mechanism to facilitate surveillance and follow-up of patients with incidentally detected findings, according to a case study published Saturday.
Enhanced imaging resolutions and utilization rates have contributed to a growth in incidental findings, with some estimates suggesting up to 20% of exams contain pancreatic incidentalomas. Follow-up for these patients also varies, which may lead to diagnostic delays and poor outcomes.
Trying to address this issue, researchers implemented a discrete field within structured radiology reports that automatically flags incidental pancreatic cysts within the electronic health record. And the tool has been a big success, the team noted July 17 in JACR.
Patients with flagged reports were more likely to be seen or discussed in the organization’s dedicated pancreas clinic (50.3% vs. 16.7% of unflagged reports) and more likely to receive follow-up imaging (50% vs. 25.5%).
The model is easily replicable, the authors noted, and, due to its benefits, has already been applied to other findings.
“Based on the success of this initial application, we have received requests from other services to implement similar discrete reporting fields and have been able to successfully replicate this design for reporting of incidental adrenal lesions,” William C. Smith, MD, a radiologist at the University of Texas Southwestern Medical Center in Dallas, and colleagues added.
For their study, Smith et al. first implemented the mechanism in April 2016. They looked over CT and MRI reports with incidental pancreatic findings over a two-year period, keying in on flagged vs. unflagged reports. The group also assessed patients’ likelihood of follow-up, including additional imaging, endoscopic ultrasound, surgery and other outcomes.
In addition improved follow-up care, flagged reports were more likely to undergo appropriate management of actionable findings compared to unflagged patients (37.1% vs. 21.7%).
“Our results suggest that the benefits of implementing the discrete field may have been driven primarily by facilitating [an] increase in patient referral to [the] pancreas cancer prevention clinic, which was our primary outcome measure,” the authors noted in the study.
Read the entire study in the Journal of the American College of Radiology here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.