Mabotuwana Thusitha, Hall Christopher S, Hombal Vadiraj, Pai Prashanth, Raghavan Usha Nandini, Regis Shawn, McKee Brady, Dalal Sandeep, Wald Christoph, Gunn Martin L
Radiology Solutions, Philips Healthcare, 22100 Bothell Everett Hwy, Bothell, WA 98021.
Department of Radiology, University of Washington, Seattle, WA.
AJR Am J Roentgenol. 2019 Jun;212(6):1287-1294. doi: 10.2214/AJR.18.20586. Epub 2019 Mar 12.
Radiology reports often contain follow-up imaging recommendations. Failure to comply with these recommendations in a timely manner can lead to poor patient outcomes, complications, and legal liability. As such, the primary objective of this research was to determine adherence rates to follow-up recommendations. Radiology-related examination data, including report text, for examinations performed between June 1, 2015, and July 31, 2017, were extracted from the radiology departments at the University of Washington (UW) and Lahey Hospital and Medical Center (LHMC). The UW dataset contained 923,885 examinations, and the LHMC dataset contained 763,059 examinations. A 1-year period was used for detection of imaging recommendations and up to 14-months for the follow-up examination to be performed. On the basis of an algorithm with 97.9% detection accuracy, the follow-up imaging recommendation rate was 11.4% at UW and 20.9% at LHMC. Excluding mammography examinations, the overall follow-up imaging adherence rate was 51.9% at UW (range, 44.4% for nuclear medicine to 63.0% for MRI) and 52.0% at LHMC (range, 30.1% for fluoroscopy to 63.2% for ultrasound) using a matcher algorithm with 76.5% accuracy. This study suggests that follow-up imaging adherence rates vary by modality and between sites. Adherence rates can be influenced by various legitimate factors. Having the capability to identify patients who can benefit from patient engagement initiatives is important to improve overall adherence rates. Monitoring of follow-up adherence rates over time and critical evaluation of variation in recommendation patterns across the practice can inform measures to standardize and help mitigate risk.
放射学报告通常包含随访影像学建议。未能及时遵守这些建议可能导致患者预后不良、出现并发症以及承担法律责任。因此，本研究的主要目的是确定对随访建议的依从率。从华盛顿大学（UW）和拉希医院及医疗中心（LHMC）的放射科提取了2015年6月1日至2017年7月31日期间进行的放射学相关检查数据，包括报告文本。UW数据集包含923,885次检查，LHMC数据集包含763,059次检查。使用1年时间来检测影像学建议，并使用长达14个月的时间来进行随访检查。基于一种检测准确率为97.9%的算法，UW的随访影像学建议率为11.4%，LHMC为20.9%。排除乳腺摄影检查后，使用准确率为76.5%的匹配算法，UW的总体随访影像学依从率为51.9%（范围为核医学的44.4%至MRI的63.0%），LHMC为52.0%（范围为透视的30.1%至超声的63.2%）。本研究表明，随访影像学依从率因检查方式和不同机构而异。依从率可能受到各种合理因素的影响。有能力识别能从患者参与举措中受益的患者对于提高总体依从率很重要。随着时间推移监测随访依从率以及对整个医疗机构建议模式的差异进行严格评估可为标准化措施提供依据，并有助于降低风险。
