Journal of the American College of Radiology : JACR
-
Incidental pulmonary nodules that require follow-up are often noted on chest CT. Evidence-based guidelines regarding appropriate follow-up have been published, but the rate of adherence to guideline recommendations is unknown. Furthermore, it is unknown whether the radiology report affects the nodule follow-up rate. ⋯ Incidental pulmonary nodules detected on CT pulmonary angiography are common and are frequently not followed up appropriately. Although the inclusion of a pulmonary nodule in the impression section of a radiology report is helpful, it does not ensure follow-up. Better systems for appropriate identification and follow-up of incidental findings are needed.
-
With the overall rise in the use of medical imaging over the past two decades, overutilization has become a major concern. The ACR Appropriateness Criteria (AC) are an evidence-based, web-based, peer-reviewed resource designed to assist clinicians in making the most appropriate imaging decisions. In this literature review, the authors assess the current knowledge, utilization, and education of the AC among undergraduate and graduate medical education trainees and practicing physicians in both radiologic and nonradiologic specialties. ⋯ The low rate of incorporation of the AC into clinical practice may reflect the lack of formal training in appropriate imaging order practices, specifically in the use of the AC, in both undergraduate and graduate medical education. The integration of the AC into decision support may reduce overutilization, but this has not been fully studied. Greater integration of the AC into medical training would require more universal physician buy-in to use the AC as a resource to optimize imaging utilization. This further requires sustained efforts to improve the "user-friendliness" of the AC and maximization of collaboration with nonradiology specialties in the development of the AC.
-
The aim of this study was to assess the effect of applying ACR Lung-RADS in a clinical CT lung screening program on the frequency of positive and false-negative findings. ⋯ The application of ACR Lung-RADS increased the positive predictive value in our CT lung screening cohort by a factor of 2.5, to 17.3%, without increasing the number of examinations with false-negative results.
-
The aim of this study was to compare the frequency and liability costs associated with radiology malpractice claims relative to other medical services and to evaluate the clinical context and case disposition associated with radiology malpractice claims. ⋯ Radiology malpractice claims most commonly involve diagnosis-related allegations in the outpatient setting, particularly cancer diagnoses, with approximately one-third of claims resulting in payouts to the claimants.