Incidental findings on brain imaging and blood tests: results from the first phase of Insight 46, a prospective observational substudy of the 1946 British birth cohort

Abstract

ObjectiveTo summarise the incidental findings detected on brain imaging and blood tests during the first wave of data collection for the Insight 46 study.DesignProspective observational sub-study of a birth cohort.SettingSingle-day assessment at a research centre in London, UK.Participants502 individuals were recruited from the MRC National Survey of Health and Development (NSHD), the 1946 British birth cohort, based on pre-specified eligibility criteria; mean age was 70.7 (SD: 0.7) and 49% were female.Outcome measuresData regarding the number and types of incidental findings were summarised as counts and percentages, and 95% confidence intervals were calculated.Results93.8% of participants completed a brain scan (n=471); 4.5% of scanned participants had a pre-defined reportable abnormality on brain MRI (n=21); suspected vascular malformations and suspected intracranial mass lesions were present in 1.9% (n=9) and 1.5% (n=7) respectively; suspected cerebral aneurysms were the single most common vascular abnormality, affecting 1.1% of participants (n=5), and suspected meningiomas were the most common intracranial lesion, affecting 0.6% of participants (n=3); 34.6% of participants had at least one abnormality on clinical blood tests (n=169), but few reached the prespecified threshold for urgent action (n=11).ConclusionsIn older adults, aged 69-71 years, potentially serious brain MRI findings were detected in around 5% of participants, and clinical blood test abnormalities were present in around one third of participants. Knowledge of the expected prevalence of incidental findings in the general population at this age is useful in both research and clinical settings.

Prevalence of incidental brain MRI findings of clinical relevance in a diverse Hispanic/Latino population

“…or Level 3 findings might offer a more accurate comparison between our study and the relevant literature conducted in a predominantly non-Latino White and relatively older age cohorts. Within this context, the rates of incidental findings in our Hispanic/Latino population are within or at the upper range of what was previously reported: 2.4% prevalence of chronic infarcts in our study population, compared to 1.2-12.0%; 6,7,9,34,35 1.0% intracranial aneurysms, compared to 0.1-2.3%; 3,4,[6][7][8][9][10][11]31,34,36 0.9% meningiomas, compared to 0.29-2.5%; 3,4,[6][7][8][9]11,34,37,38 0.5% cavernous venous malformations, compared to 0.1-2.4%; [3][4][5][6][7]9,11,31,34,36 0.6% pituitary masses, compared to 0.1-0.8%; [3][4][5][6][7]9,11,34,36 0.5% possible demyelination, compared to 0.04-0.4%; 5,11,31,36 0.2% chronic post-traumatic encephalomalacia, compared to 0.1-0.2%; 31,…”

It is not a big deal: a qualitative study of clinical biobank donation experience and motives

“…Donors’ motivation to receive additional check-up options as a form of incentive motivation was perceived as predominant by donation organisers. This finding might be ethically challenging given a high chance for receiving incidental findings, especially with particular methods and populations [ 34 ]. In our study, "full check-up" was not perceived as a potential risk by organisers or donors, which might be attributed to the novelty of such practice in Russia.…”

Incidental Findings on Brain MRI in People with HIV Infection

“…In this study, we found a rate of 33.3% in the HIV cohort, 27% in the controls. Such a wide range of prevalence has been hypothesized to be due to varying methods, populations, and sample sizes 9,15,16 . Furthermore, there is evidence that the prevalence of incidental finding detection is more likely using high-resolution MRI sequences 17 .…”

“…www.nature.com/scientificreports www.nature.com/scientificreports/ Chief among the ethical concerns posed by these findings is the necessity, timing, and context of disclosure to both patients and research participants. Generally, scientific research has followed the fundamental principle of primum non nocere (first, do no harm), as well as general duty to help and rescue 16 . The prevalence of clinically…”