Variation in Radiologists' Follow-Up Imaging Recommendations for Small Cystic Pancreatic Lesions.

Autor:	Kapoor N; Director of Diversity, Equity, and Inclusion, Quality and Patient Safety Officer, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: nkapoor@partners.org., Lacson R; Director of Education, Center for Evidence-Based Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Director of Clinical Informatics, Harvard Medical School Library of Evidence, Boston, Massachusetts., Eskian M; Research Fellow, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Cochon L; Research Fellow, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Glazer D; Medical Director of CT, and Director, Cross-Sectional Interventional Radiology (CSIR), Department or Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Ip I; Faculty, Center for Evidence-Based Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Khorasani R; Director, Center for Evidence-Based Imaging, and Vice Chair of Quality/Safety, Department of Radiology, Center for Evidence-Based Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Jazyk:	angličtina
Zdroj:	Journal of the American College of Radiology : JACR [J Am Coll Radiol] 2021 Oct; Vol. 18 (10), pp. 1405-1414. Date of Electronic Publication: 2021 Jun 24.
DOI:	10.1016/j.jacr.2021.06.007
Abstrakt:	Objective: This study aimed to determine the incidence, identify imaging and patient factors, and measure individual radiologist variation associated with follow-up recommendations for small focal cystic pancreatic lesions (FCPLs), a common incidental imaging finding. Methods: This institutional review board-approved retrospective study analyzed 146,709 reports from abdominal CTs and MRIs performed in a large academic hospital from July 1, 2016, to June 30, 2018. A trained natural language processing tool identified 4,345 reports with FCPLs, which were manually reviewed to identify those containing one or more <1.5-cm pancreatic cysts. For these patients, patient, lesion, and radiologist features and follow-up recommendations for FCPL were extracted. A nonlinear random-effects model estimated degree of variation in follow-up recommendations across radiologists at department and division levels. Results: Of 2,872 reports with FCPLs < 1.5 cm, 708 (24.7%) had FCPL-related follow-up recommendations. Average patient age was 67 years (SD ± 11). In all, 1,721 (60.0%) reports were for female patients; 59.3% of patients had only one cyst. In multivariable analysis, older patients had slightly lower follow-up recommendation rates (odds ratio [OR]: 0.98 [0.98-1.00] per additional year), and lesions associated with main duct dilatation and septation were more likely to have a follow-up recommendation (ORs: 1.93 [1.11-3.36] and 2.88 [1.89-4.38], respectively). Radiologist years in practice (P = .51), trainee presence (P = .21), and radiologist gender (P = .52) were not associated with increased follow-up recommendations. There was significant interradiologist variation in the Abdominal Imaging Division (P = .04), but not in Emergency Radiology (P = .31) or Cancer Imaging Divisions (P = .29). Discussion: Interradiologist variation significantly contributes to variability in follow-up imaging recommendations for FCPLs. (Copyright © 2021. Published by Elsevier Inc.)
Databáze:	MEDLINE
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