Communication of unexpected and significant findings on chest radiographs with an automated PACS alert system Journal Article


Authors: Hayes, S. A.; Breen, M.; McLaughlin, P. D.; Murphy, K. P.; Henry, M. T.; Maher, M. M.; Ryan, M. F.
Article Title: Communication of unexpected and significant findings on chest radiographs with an automated PACS alert system
Abstract: Purpose: An integral part of realizing the enormous potential of imaging in patient care is close communication between radiologists and referring physicians. One key element of this process is the communication of unexpected significant findings. The authors examined the performance of a PACS-based alert system in the appropriate communication of reports containing unexpected significant findings to referring physicians. Methods: A PACS-integrated key word system was developed such that an e-mail was sent to the referring clinician if a radiologist detected a significant unexpected finding. The number, source, and outcome of chest radiographic unexpected findings over a 14-month period were analyzed. The time for response of the referring physician plus time for follow-up were also examined. Results: Key words were applied to 158 of the 39,665 chest radiographs (0.4%) obtained during the study period. The emergency department was the most frequent referral location (46.2%). Final diagnostic categories included malignancy (13.9%), benign lesion (49.4%), and no abnormality (20.2%). The average time to acknowledgment by clinicians of notification was 3.1 days, although 57.6% were acknowledged within 24 hours. The mean time interval to the next relevant radiologic investigation was 26 days among the 77.8% of findings that underwent radiologic follow-up. Conclusions: The development of electronic alert systems, which are integrated into PACS, can aid greatly in report communication and eliminate the risk associated with unread reports that contain significant or unexpected findings. © 2014 American College of Radiology.
Keywords: major clinical study; follow up; lung cancer; lung embolism; radiologist; thorax radiography; incidental finding; lymphadenopathy; patient referral; predictive value; abdominal aorta aneurysm; lung nodule; hospital information system; e-mail; pacs; chest radiograph; human; article; tertiary care center; medicolegal risk; unexpected clinical findings
Journal Title: Journal of the American College of Radiology
Volume: 11
Issue: 8
ISSN: 1546-1440
Publisher: Elsevier Science, Inc.  
Date Published: 2014-08-01
Start Page: 791
End Page: 795
Language: English
DOI: 10.1016/j.jacr.2014.01.017
PROVIDER: scopus
PUBMED: 24818987
DOI/URL:
Notes: Export Date: 2 September 2014 -- Source: Scopus
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  1. Sara Anne Hayes
    33 Hayes