Mark D Bobbin1, Ivan K Ip1, V Anik Sahni2, Atul B Shinagare1, Ramin Khorasani1. 1. Department of Radiology and Center for Evidence-Based Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 2. Department of Radiology and Center for Evidence-Based Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: vassahni@hotmail.com.
Abstract
PURPOSE: To describe the variation in radiologists' follow-up recommendations for focal cystic pancreatic lesions (FCPL) after publication of the 2010 ACR incidental findings White Paper and determine adherence to guidance of the ACR Incidental Findings Committee. METHODS: Institutional Review Board approval was obtained for this retrospective, HIPAA-compliant observational study. Patients with FCPL were identified from abdominal CT and MRI reports generated in 2013 using natural language processing software. Patient-, lesion-, and radiologist-specific variables were recorded. Primary outcome was whether a follow-up recommendation was made, and if it included a specific study or intervention and recommended time for follow-up. χ2 and logistic regression models were used to identify predictors and controlled for recommendation. These data were compared with 2009 data obtained before the White Paper's publication. Secondary outcome was adherence to the ACR's guidance. RESULTS: During calendar year 2013, 1,377 reports describing FCPLs were identified in 1,038 patients. After excluding examinations from low-volume readers (n = 80), radiologists recommended follow-up imaging in 13.5% (175/1,297) of cases, a decrease from 2009 when it was recommended in 23.7% (221/933) of cases (P < .001). Findings were consistent across radiologists after controlling for patient- and lesion-specific variables. Variability in follow-up recommendations persists between radiologists (2.4-fold difference in 2013 versus 2.8-fold difference in 2009). Radiologists adhered to ACR guidance principles 47.4% of the time. CONCLUSIONS: Despite published guidance recommendations and reported awareness of them, fewer than half of follow-up recommendations for FCPL are consistent with the guidance and considerable variability persists among radiologists.
PURPOSE: To describe the variation in radiologists' follow-up recommendations for focal cystic pancreatic lesions (FCPL) after publication of the 2010 ACR incidental findings White Paper and determine adherence to guidance of the ACR Incidental Findings Committee. METHODS: Institutional Review Board approval was obtained for this retrospective, HIPAA-compliant observational study. Patients with FCPL were identified from abdominal CT and MRI reports generated in 2013 using natural language processing software. Patient-, lesion-, and radiologist-specific variables were recorded. Primary outcome was whether a follow-up recommendation was made, and if it included a specific study or intervention and recommended time for follow-up. χ2 and logistic regression models were used to identify predictors and controlled for recommendation. These data were compared with 2009 data obtained before the White Paper's publication. Secondary outcome was adherence to the ACR's guidance. RESULTS: During calendar year 2013, 1,377 reports describing FCPLs were identified in 1,038 patients. After excluding examinations from low-volume readers (n = 80), radiologists recommended follow-up imaging in 13.5% (175/1,297) of cases, a decrease from 2009 when it was recommended in 23.7% (221/933) of cases (P < .001). Findings were consistent across radiologists after controlling for patient- and lesion-specific variables. Variability in follow-up recommendations persists between radiologists (2.4-fold difference in 2013 versus 2.8-fold difference in 2009). Radiologists adhered to ACR guidance principles 47.4% of the time. CONCLUSIONS: Despite published guidance recommendations and reported awareness of them, fewer than half of follow-up recommendations for FCPL are consistent with the guidance and considerable variability persists among radiologists.
Authors: Arlene Casey; Emma Davidson; Michael Poon; Hang Dong; Daniel Duma; Andreas Grivas; Claire Grover; Víctor Suárez-Paniagua; Richard Tobin; William Whiteley; Honghan Wu; Beatrice Alex Journal: BMC Med Inform Decis Mak Date: 2021-06-03 Impact factor: 2.796