Comparing thoracic and abdominal subspecialists' follow-up recommendations for abdominal findings identified on chest CT

Anna H Zhao; Daniel I Glazer; Mark M Hammer; Kristine S Burk; Pamela J DiPiro; Ramin Khorasani

doi:10.1007/s00261-023-03821-4

Comparing thoracic and abdominal subspecialists' follow-up recommendations for abdominal findings identified on chest CT

Abdom Radiol (NY). 2023 Apr;48(4):1468-1478. doi: 10.1007/s00261-023-03821-4. Epub 2023 Feb 3.

Authors

Anna H Zhao^{1

2}, Daniel I Glazer^{3

4}, Mark M Hammer^{1

2}, Kristine S Burk^{1

2}, Pamela J DiPiro^{1

2}, Ramin Khorasani^{1

2}

Affiliations

¹ Center for Evidence-Based Imaging, Brigham and Women's Hospital, Harvard Medical School, One Brigham Circle, 1620 Tremont Street, Third Floor, Suite 3010, Boston, MA, 02120, USA.
² Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
³ Center for Evidence-Based Imaging, Brigham and Women's Hospital, Harvard Medical School, One Brigham Circle, 1620 Tremont Street, Third Floor, Suite 3010, Boston, MA, 02120, USA. dglazer@bwh.harvard.edu.
⁴ Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA. dglazer@bwh.harvard.edu.

PMID: 36732409
DOI: 10.1007/s00261-023-03821-4

Abstract

Purpose: To compare thoracic and abdominal radiologists' follow-up recommendations for abdominal findings identified on chest CT.

Methods: This Institutional Review Board-exempt, retrospective study was performed at a large academic medical center with subspecialty radiology divisions. We used a combination of natural language processing and manual reviews to identify chest CT reports with and without abdominal findings that were interpreted by thoracic radiologists in 2019. Three random samples of reports were reviewed by two subspecialty trained abdominal radiologists for their agreement with thoracic radiologists' reporting: abdominal findings with follow-up recommendation (Group 1), abdominal findings without follow-up recommendation (Group 2), and no abdominal findings reported (Group 3). Primary outcome was agreement between thoracic and abdominal radiologists for the need for follow-up of abdominal findings. Secondary outcomes were agreement between subspecialists for the presence of abdominal findings and referring clinician adherence to recommendations. Fischer's exact test was used to compare proportions.

Results: Abdominal radiologists agreed with need for follow-up in 48.5% (16/33) of Group 1 cases and agreed follow-up was not necessary for 100% (34/34) of Group 2 cases (p < 0.001). Abdominal radiologists identified abdominal findings in 31.4% (11/35) of Group 3 cases, none of which required follow-up. Referring clinician adherence to thoracic radiologist follow-up recommendations for abdominal findings was 13/33 (39.4%).

Conclusion: Abdominal radiologists frequently disagreed with thoracic radiologist recommendations for follow-up of abdominal findings on chest CT. Chest radiologists may consider abdominal subspecialty consultation or clinical decision support to reduce unnecessary imaging.

Keywords: Abdominal findings; Cross-subspecialty workflows; Subspecialty radiologists.

MeSH terms

Humans
Radiography
Radiologists
Radiology*
Retrospective Studies
Tomography, X-Ray Computed*