Does radiologist recommendation for follow-up with the same imaging modality contribute substantially to high-cost imaging volume? Export

@article{citeulike:2498880, abstract = {PURPOSE: To retrospectively measure repeat rates for high-cost imaging studies, determining their causes and trends, and the impact of radiologist recommendations for a repeat examination on imaging volume. MATERIALS AND METHODS: This HIPAA-compliant study had institutional review board approval, with waiver of informed consent. Repeat examination was defined as a same-modality examination performed in the same patient within 0 days to 7 months of a first examination. From a database of all radiology examinations (>2.9 million) at one institution from May 1996 to June 2003, a computerized search identified head, spine, chest, and abdominal computed tomographic (CT), brain and spine magnetic resonance (MR) imaging, pelvic ultrasonography (US), and nuclear cardiology examinations with a prior examination of the same type within 7 months. Examination pairs were subdivided into studies repeated at less than 2 weeks, between 2 weeks and 2 months, or between 2 and 7 months. Automated classification of radiology reports revealed whether a repeat examination from June 2002 to June 2003 had been preceded by a radiologist recommendation on the prior report. Trends over time were analyzed with linear regression, and 95\% confidence intervals were calculated. RESULTS: Between July 2002 and June 2003, 31 111 of 100 335 examinations (31\%) were repeat examinations. Body CT (9057 of 20 177 [45\%] chest and 8319 of 22 438 [37\%] abdomen) and brain imaging (6823 of 18 378 [37\%] CT and 3427 of 11 455 [30\%] MR imaging) represented the highest repeat categories. Among five high-cost, high-volume imaging examinations, 6426 of 85 014 (8\%) followed a report with a radiologist recommendation. Most common indications for examination repetition were neurologic surveillance within 2 weeks and cancer follow-up at 2-7 months. From 1997 to mid-2003, MR imaging and CT repeat rates increased (0.71\% per year [P < .01] and 1.87\% per year [P < .01], respectively). CONCLUSION: Repeat examinations account for nearly one-third of high-cost radiology examinations and represent an increasing proportion of such examinations. Most repeat examinations are initiated clinically without a recommendation by a radiologist.}, address = {Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114, USA.}, author = {Lee, S. I. and Saokar, A. and Dreyer, K. J. and Weilburg, J. B. and Thrall, J. H. and Hahn, P. F.}, citeulike-article-id = {2498880}, citeulike-linkout-0 = {http://dx.doi.org/10.1148/radiol.2423051754}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/17325070}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=17325070}, doi = {10.1148/radiol.2423051754}, issn = {0033-8419}, journal = {Radiology}, keywords = {follow-up, radiology, utilization}, month = {March}, number = {3}, pages = {857--864}, posted-at = {2008-03-10 04:38:45}, priority = {2}, title = {Does radiologist recommendation for follow-up with the same imaging modality contribute substantially to high-cost imaging volume?}, url = {http://dx.doi.org/10.1148/radiol.2423051754}, volume = {242}, year = {2007} }

TY - JOUR ID - citeulike:2498880 L3 - citeulike-article-id:2498880 N2 - PURPOSE: To retrospectively measure repeat rates for high-cost imaging studies, determining their causes and trends, and the impact of radiologist recommendations for a repeat examination on imaging volume. MATERIALS AND METHODS: This HIPAA-compliant study had institutional review board approval, with waiver of informed consent. Repeat examination was defined as a same-modality examination performed in the same patient within 0 days to 7 months of a first examination. From a database of all radiology examinations (>2.9 million) at one institution from May 1996 to June 2003, a computerized search identified head, spine, chest, and abdominal computed tomographic (CT), brain and spine magnetic resonance (MR) imaging, pelvic ultrasonography (US), and nuclear cardiology examinations with a prior examination of the same type within 7 months. Examination pairs were subdivided into studies repeated at less than 2 weeks, between 2 weeks and 2 months, or between 2 and 7 months. Automated classification of radiology reports revealed whether a repeat examination from June 2002 to June 2003 had been preceded by a radiologist recommendation on the prior report. Trends over time were analyzed with linear regression, and 95% confidence intervals were calculated. RESULTS: Between July 2002 and June 2003, 31 111 of 100 335 examinations (31%) were repeat examinations. Body CT (9057 of 20 177 [45%] chest and 8319 of 22 438 [37%] abdomen) and brain imaging (6823 of 18 378 [37%] CT and 3427 of 11 455 [30%] MR imaging) represented the highest repeat categories. Among five high-cost, high-volume imaging examinations, 6426 of 85 014 (8%) followed a report with a radiologist recommendation. Most common indications for examination repetition were neurologic surveillance within 2 weeks and cancer follow-up at 2-7 months. From 1997 to mid-2003, MR imaging and CT repeat rates increased (0.71% per year [P < .01] and 1.87% per year [P < .01], respectively). CONCLUSION: Repeat examinations account for nearly one-third of high-cost radiology examinations and represent an increasing proportion of such examinations. Most repeat examinations are initiated clinically without a recommendation by a radiologist. IS - 3 JF - Radiology SN - 0033-8419 AD - Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA 02114, USA. EP - 864 TI - Does radiologist recommendation for follow-up with the same imaging modality contribute substantially to high-cost imaging volume? VL - 242 SP - 857 KW - follow-up KW - radiology KW - utilization AU - Lee, SI AU - Saokar, A AU - Dreyer, KJ AU - Weilburg, JB AU - Thrall, JH AU - Hahn, PF PY - 2007/03// UR - http://dx.doi.org/10.1148/radiol.2423051754 ER -