Primary Care Provider Management of Incidental Imaging Findings

December 6, 2016

Incidental findings on imaging reports are treated in different ways by PCPs.

Radiologists can help primary care providers (PCPs) best use information conveyed in imaging reports, including incidental imaging findings, according to a study published in Radiology.

Researchers from Pennsylvania, Maryland, and California explored provider and patient characteristics that influence how PCPs communicate and manage incidental imaging findings. Thirty PCPs participated in this study, 15 family medicine and 15 internal medicine providers. Using semistructured interviews, the researchers explored concerns and perspectives of the PCPs on receiving and acting on incidental imaging findings. The open-ended questions were designed to elicit a range of responses rather than quantifiable data.

The results showed that some PCPs felt that they had to pursue costly follow-up for incidental imaging findings of limited clinical importance, while others did not act on findings that were unfamiliar or that occurred in an unusual clinical context when follow-up recommendations were not given. They mentioned that the challenges of researching the clinical importance of these findings or seeking specialist consultation led to inaction.

Some PCPs reported using a uniform approach to communicate and manage incidental findings, and others adapted their approach to the patient and the finding. Sometimes PCP characteristics such as follow-up style superseded patient characteristics. At other times, patient characteristics such as health literacy superseded PCP characteristics.

The researchers concluded that there were a variety of objective and subjective factors that influence how PCPs communicate and manage incidental imaging findings, suggesting that some patients may receive inappropriate follow-up of incidental imaging findings and present an opportunity for radiologists to help PCPs and patients to best use the information conveyed in imaging reports.