Predictors of Physician Agreement With Radiologist-Recommended Follow-up Imaging.

Autor:	Flash M; Department of Radiology, Hospital of the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, Pennsylvania., Lynch EA; Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Lacson R; Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Guenette JP; Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Desai S; Vice President Quality and Associate Chief Medical Officer, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Kapoor N; Associate Chair of Quality and Safety, Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: nkapoor@bwh.harvard.edu.
Jazyk:	angličtina
Zdroj:	Journal of the American College of Radiology : JACR [J Am Coll Radiol] 2024 Nov 17. Date of Electronic Publication: 2024 Nov 17.
DOI:	10.1016/j.jacr.2024.11.006
Abstrakt:	Objective: Although recommendations for additional imaging are common in radiology reports, completion of follow-up imaging does not always occur, which could reflect disagreement between radiologist and referring provider. We assessed how frequently referring providers agree with radiologists' follow-up recommendations, reasons for disagreement, and factors associated with radiologist-referring provider agreement. Methods: This institutional review board-exempt, retrospective study was performed at a large academic center. A PACS-integrated tool allowed radiologists to send follow-up imaging recommendations to referring providers, who used the tool to document agreement or disagreement with recommendations. The study included recommendations sent for outpatients between October 21, 2019, and October 31, 2022. Multivariable logistic regression analysis was performed to identify patient, radiologist, and imaging examination factors associated with radiologist-referring provider agreement. Results: Of the 9,406 recommendations meeting inclusion criteria, 8,331 (88.6%) resulted in agreement. The most common reason for disagreement was that the recommendation was considered not clinically relevant (44.5%, 478 of 1,075). The following factors were associated with low rates of agreement: referring provider being a surgeon (odds ratio [OR] 0.73, P < .001) or recommendation for follow-up nuclear imaging (OR 0.64, P = .012). The odds of agreement were higher for recommendations made by thoracic radiologists (OR 1.41, P = .002) and for recommendations with longer follow-up time frames (weeks) (OR 1.03, P < .001). Patient race, ethnicity, insurance type, and living in a socio-economically disadvantaged neighborhood were not significantly associated with radiologist-referring provider agreement. Discussion: Referring providers frequently agree with follow-up imaging recommendations made by radiologists for outpatients, and patient demographics and socio-economic factors do not seem to significantly impact radiologist-referring provider agreement. (Copyright © 2024 American College of Radiology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu