Absolute Recommendations for Imaging Taken More Seriously

Patients are more likely to be sent for radiologist-recommended exams if they are absolute recommendations, rather than conditional ones, according to a study published in the Journal of the American College of Radiology.

Researchers from Harvard Medical School, Boston, and Lahey Hospital and Medical Center, Burlington, MA, performed a retrospective study to evaluate the association between the wording of radiologist recommendations for chest CT with the likelihood of recommendation adherence and the diagnostic yield of the recommended follow-up CT imaging.

The researchers looked at 29,138 outpatient chest X-ray studies performed at a tertiary care academic medical center in 2008, to identify examinations that had conditional or absolute recommendations for chest CT.

The findings showed that chest CTs were recommended for 1,316 (4.5%) of outpatient chest X-ray studies. A total of 519 (39.4%) were conditional recommendations and 797 (60.6%) were absolute recommendations. ”Patients with absolute recommendations were significantly more likely to undergo follow-up chest CT within 90 days than patients with conditional recommendations (67.8% versus 45.8%, respectively,” wrote the researchers.

While absolute recommendations did result in more tests, the researchers did not find a significant difference between the conditional and absolute recommendation groups with regard to the incidence of clinically relevant corresponding findings or on follow-up CT.