Absolute Recommendations for Imaging Taken More Seriously

Absolute recommendations for imaging, rather than conditional recommendations, result in more patients receiving the exams.

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.