Predictors of Physician Agreement With Radiologist-Recommended Follow-up Imaging.

Area of Science:

• Radiology and Medical Imaging
• Healthcare Communication
• Clinical Decision Support

Background:

• Follow-up imaging recommendations are common in radiology reports.
• Completion rates for recommended follow-up imaging vary, potentially due to radiologist-referring provider disagreement.
• Understanding agreement is crucial for optimizing patient care pathways.

Purpose of the Study:

• To assess the frequency of referring provider agreement with radiologist follow-up imaging recommendations.
• To identify reasons for disagreement between radiologists and referring providers.
• To determine factors associated with agreement on follow-up imaging.

Main Methods:

• Retrospective study at a large academic center using a PACS-integrated tool for recommendation documentation.
• Included outpatient recommendations sent between October 2019 and October 2022.
• Multivariable logistic regression analyzed factors associated with agreement.

Main Results:

• High agreement rate (88.6%) between radiologists and referring providers.
• Most common disagreement reason: recommendation not clinically relevant (44.5%).
• Lower agreement for surgeons and nuclear imaging; higher agreement for thoracic radiologists and longer follow-up intervals.

Conclusions:

• Referring providers largely agree with radiologist follow-up imaging recommendations.
• Patient demographics and socioeconomic factors do not significantly influence agreement.
• Focusing on clinical relevance can improve adherence to imaging recommendations.