Quality Intervention Program To Reduce Unnecessary Radiology Follow-Up Imaging

Jamie Hui, MD Center for Health Services Research Virginia Mason Medical Center Seattle, WashingtonMedicalResearch.com Interview with:
Jamie Hui, MD
Center for Health Services Research
Virginia Mason Medical Center
Seattle, Washington

MedicalResearch.com: What are the main findings of the study?

Dr. Hui: Through a quality improvement intervention aimed at how radiologists report on findings in female pelvic ultrasound examinations, we were able to decrease the number of unnecessary recommendations for follow-up imaging of benign adnexal cysts, preventing duress for these women.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Hui: Not surprisingly, educational efforts helped reduce the number of exams with unnecessary follow-up recommended.  However, the most important impact in changing radiologists reporting behavior was our use of the 2010 Society for Radiologists in Ultrasound (SRU) consensus statement for characterizing and reporting adnexal cysts seen by ultrasound.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Hui: There are several take away points from this study.

For clinicians, first, evidence-based guidelines are a very helpful tool for radiologists in accurate reporting and reduction of variability. The acceptance of an external expert consensus guideline added credibility and reassurance for our radiologists.

Second, radiologists themselves may be able to reduce self-referral regarding unnecessary follow-up imaging. In our project, we found that consensus criteria helped us reduce unnecessary recommendations for pelvic ultrasound follow-up exams. Finally, buy-in and continued active engagement by the radiology team is paramount to a successful quality improvement project.

For patients, we are improving care by doing less, rather than doing more. By identifying which pelvic cysts are benign in the initial evaluation, we are preventing unnecessary worry and unnecessary cost.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Hui: One potential question is whether it is possible to miss malignant pathology that is characterized as benign based on the SRU consensus criteria. To date, we have no known cases that would fall under this misdiagnosis category, further adding credibility to the consensus criteria guidelines.

Citation:

A Quality Improvement Initiative to Reduce Unnecessary Follow-up Imaging for Adnexal Lesions

Hui JS, Kramer DJ, Blackmore CC, Hashimoto BE, Coy DL
J Am Coll Radiol. 2014 Apr;11(4):373-7.
doi: 10.1016/j.jacr.2013.07.002. Epub 2013 Oct 17.

 

Last Updated on April 24, 2014 by Marie Benz MD FAAD