Computer-assisted Reporting and Decision Support Increases Compliance with Follow-up Imaging and Hormonal Screening of Adrenal Incidentalomas
Copyright © 2021 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved..
OBJECTIVE: To assess the impact of using a computer-assisted reporting and decision support (CAR/DS) tool at the radiologist point-of-care on ordering provider compliance with recommendations for adrenal incidentaloma workup.
METHOD: Abdominal CT reports describing adrenal incidentalomas (2014 - 2016) were retrospectively extracted from the radiology database. Exclusion criteria were history of cancer, suspected functioning adrenal tumor, dominant nodule size < 1 cm or ≥ 4 cm, myelolipomas, cysts, and hematomas. Multivariable logistic regression models were employed to predict follow-up imaging (FUI) and hormonal screening orders as a function of patient age and sex, nodule size, and CAR/DS use. CAR/DS reports were compared to conventional reports regarding ordering provider compliance with, frequency, and completeness of, guideline-warranted recommendations for FUI and hormonal screening of adrenal incidentalomas using Chi-square test.
RESULT: Of 174 patients (mean age 62.4; 51.1% women) with adrenal incidentalomas, 62% (108/174) received CAR/DS-based recommendations versus 38% (66/174) unassisted recommendations. CAR/DS use was an independent predictor of provider compliance both with FUI (Odds Ratio [OR]=2.47, p = 0.02) and hormonal screening (OR=2.38, p = 0.04). CAR/DS reports recommended FUI (97.2%,105/108) and hormonal screening (87.0%,94/108) more often than conventional reports (respectively, 69.7% [46/66], 3.0% [2/66], both p <0.0001). CAR/DS recommendations more frequently included instructions for FUI time, protocol, and modality than conventional reports (all p <0.001).
CONCLUSION: Ordering providers were at least twice as likely to comply with report recommendations for FUI and hormonal evaluation of adrenal incidentalomas generated using CAR/DS versus unassisted reporting. CAR/DS-directed recommendations were more adherent to guidelines than those generated without.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Academic radiology - 29(2022), 2 vom: 21. Feb., Seite 236-244 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Almeida, Renata R [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 25.01.2022 Date Revised 25.01.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.acra.2021.01.019 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM321433483 |
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| 100 | 1 | |a Almeida, Renata R |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Computer-assisted Reporting and Decision Support Increases Compliance with Follow-up Imaging and Hormonal Screening of Adrenal Incidentalomas |
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| 500 | |a Date Revised 25.01.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: To assess the impact of using a computer-assisted reporting and decision support (CAR/DS) tool at the radiologist point-of-care on ordering provider compliance with recommendations for adrenal incidentaloma workup | ||
| 520 | |a METHOD: Abdominal CT reports describing adrenal incidentalomas (2014 - 2016) were retrospectively extracted from the radiology database. Exclusion criteria were history of cancer, suspected functioning adrenal tumor, dominant nodule size < 1 cm or ≥ 4 cm, myelolipomas, cysts, and hematomas. Multivariable logistic regression models were employed to predict follow-up imaging (FUI) and hormonal screening orders as a function of patient age and sex, nodule size, and CAR/DS use. CAR/DS reports were compared to conventional reports regarding ordering provider compliance with, frequency, and completeness of, guideline-warranted recommendations for FUI and hormonal screening of adrenal incidentalomas using Chi-square test | ||
| 520 | |a RESULT: Of 174 patients (mean age 62.4; 51.1% women) with adrenal incidentalomas, 62% (108/174) received CAR/DS-based recommendations versus 38% (66/174) unassisted recommendations. CAR/DS use was an independent predictor of provider compliance both with FUI (Odds Ratio [OR]=2.47, p = 0.02) and hormonal screening (OR=2.38, p = 0.04). CAR/DS reports recommended FUI (97.2%,105/108) and hormonal screening (87.0%,94/108) more often than conventional reports (respectively, 69.7% [46/66], 3.0% [2/66], both p <0.0001). CAR/DS recommendations more frequently included instructions for FUI time, protocol, and modality than conventional reports (all p <0.001) | ||
| 520 | |a CONCLUSION: Ordering providers were at least twice as likely to comply with report recommendations for FUI and hormonal evaluation of adrenal incidentalomas generated using CAR/DS versus unassisted reporting. CAR/DS-directed recommendations were more adherent to guidelines than those generated without | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Adrenal Incidentaloma | |
| 650 | 4 | |a Adrenal Nodule | |
| 650 | 4 | |a Computed Tomography (CT) | |
| 650 | 4 | |a Computer-assisted reporting | |
| 650 | 4 | |a Decision Support Abbreviations Computer-assisted reporting and decision support (CAR/DS) | |
| 650 | 4 | |a Follow-up Imaging (FUI) | |
| 650 | 4 | |a Hounsfield Units (HU) | |
| 650 | 4 | |a Magnetic resonance Imaging (MRI) | |
| 650 | 4 | |a Odds Ratio (OR) | |
| 700 | 1 | |a Bizzo, Bernardo C |e verfasserin |4 aut | |
| 700 | 1 | |a Singh, Ramandeep |e verfasserin |4 aut | |
| 700 | 1 | |a Andriole, Katherine P |e verfasserin |4 aut | |
| 700 | 1 | |a Alkasab, Tarik K |e verfasserin |4 aut | |
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