Patient Factor Disparities in Imaging Follow-Up Rates After Incidental Abdominal Findings

Cho, Joshua K.; Zafar, Hanna M.; Lalevic, Darco; Cook, Tessa S.

doi:10.2214/ajr.18.20083

Cited by 25 publications

(7 citation statements)

References 29 publications

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“…These results are rather interesting as majority of the radiological reports (up to 68%) had recommended a follow-up of the pulmonary nodules [ 25 ] indicating a significant lack of adequate nodule work-up in many patients with potential early-stage cancer. Several pitfalls are described in the literature that may be responsible for inadequate management of IPNs [ 25 , 33 , 79 , 80 , 81 ] showing that, even if the radiologist initiates the IPN management process by documenting them in the radiology report, he is not solely responsible that IPNs are often neglected. Different health care providers and patients also represent important factors in the success of IPN management.…”

Section: Main Textmentioning

confidence: 99%

Incidental Pulmonary Nodules – What Do We Know in 2022

et al. 2022

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Lung cancer (LC) is the leading cause of cancer-related mortality worldwide, and early LC diagnosis can significantly improve outcomes and survival rates in affected patients. Implementation of LC screening programs using low-dose computed tomography CT in high-risk subjects aims to detect LC as early as possible, but so far, adoption of screening programs into routine clinical care has been very slow. In recent years, the use of CT has significantly increased the rate of incidentally detected pulmonary nodules. Although most of those incidental pulmonary nodules (IPNs) are benign, some of them represent early-stage LC. Given the large number of IPNs detected in the range of several millions each year, this represents an additional, maybe even larger, opportunity to drive stage shift in LC diagnosis, next to LC screening programs. Comprehensive evaluation and targeted work-up of IPNs are mandatory to identify the malignant nodules from the crowd, and several guidelines provide radiologists and physicians’ guidance on IPN assessment and management. However, IPNs still seem to be inadequately processed due to various reasons including insufficient reporting in the radiological report, missing communication between stakeholders, absence of patient tracking systems, and uncertainty regarding responsibilities for the IPN management. In recent years, several approaches such as lung nodule programs, patient tracking software, artificial intelligence, and communication software were introduced into clinical practice to address those shortcomings. This review evaluates the current situation of IPN management and highlights recent developments in process improvement to achieve first steps toward stage shift in LC diagnosis.

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Section: Main Textmentioning

confidence: 99%

Incidental Pulmonary Nodules – What Do We Know in 2022

et al. 2022

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“…Highlighting the scope of the problem, in a cohort of 1513 patients with potentially actionable incidental findings on abdominal radiography, 36.6% did not undergo follow-up imaging within 1 year and were lost to follow-up. 3 Similar discrepancies have been reported with different imaging modalities in various health care settings and likely stem from reporting ambiguities, misinterpretations by referring physicians, or inconsistent communication to providers or patients and may be compounded by socioeconomic and healthliteracy factors.…”

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confidence: 69%

Improving Communication of Incidental Imaging Findings

Oren

Gersh

Bhatt

2021

Mayo Clinic Proceedings

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“…Disparities in health care imaging have been previously described, somewhat extensively in the field of mammography, and more generally with regard to the frequency of missed care opportunities, as well as differences in wait times to receive advanced imaging (12)(13)(14)(15)(16)(17)(18). A more recent study of the follow-up of incidental findings on abdominal imaging demonstrated that elderly patients and emergency department patients were less likely to complete follow-up imaging and that insurance status and race may also contribute to differences in follow-up rates (19). However, the literature examining disparities in radiology remains sparse.…”

Section: Discussionmentioning

confidence: 99%

Disparities in PET Imaging for Prostate Cancer at a Tertiary Academic Medical Center

et al. 2020

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The purpose of this study was to evaluate differences between patients receiving 18 F-fluciclovine and 68 Ga-prostate specific membrane antigen ( 68 Ga-PSMA-11) for biochemical recurrent prostate cancer at a tertiary medical center.Methods: All 18 F-fluciclovine and 68 Ga-PSMA-11 PET studies performed at the University of California, San Francisco 10/2015-1/2020 were reviewed. Age, race/ethnicity, primary language, BMI, insurance type, and home address were obtained through the electronic medical record. A logistic regression model was used to evaluate the predictor variables.Results: 1,502 patients received 68 Ga-PSMA-11 and 254 patients received 18 F-fluciclovine.Black patients had increased odds of receiving imaging with 18 F-fluciclovine versus 68 Ga-PSMA-11 compared to non-Hispanic white patients (OR 3.88, 95% CI 1.90-7.91). There were no other statistically significant differences. Conclusion:In patients receiving molecular imaging for prostate cancer at a single U.S. tertiary medical center, access to 68 Ga-PSMA-11 for Black patients was limited, compared to non-Hispanic white patients, by a factor of nearly four.

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Patient Factor Disparities in Imaging Follow-Up Rates After Incidental Abdominal Findings

Cited by 25 publications

References 29 publications

Incidental Pulmonary Nodules – What Do We Know in 2022

Incidental Pulmonary Nodules – What Do We Know in 2022

Improving Communication of Incidental Imaging Findings

Disparities in PET Imaging for Prostate Cancer at a Tertiary Academic Medical Center

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