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Cumulative Effect of Targeted Interventions on Radiologist Recommendations for Additional Imaging
Nooshin Abbasi1, Neena Kapoor1, Ronilda Lacson1
1Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115.
Radiology
|June 3, 2025
Summary
Multifaceted technology interventions significantly reduced radiologist recommendations for additional imaging (RAIs), improving their actionability and resolution over eight years.
Area of Science:
- Radiology and Medical Imaging
- Health Informatics
- Quality Improvement in Healthcare
Background:
- Ambiguous or unnecessary radiologist recommendations for additional imaging (RAIs) contribute to overuse of imaging and potential diagnostic errors.
- Optimizing RAIs is crucial for improving healthcare efficiency and patient safety.
- A technology-enabled, multifaceted approach was investigated to address these issues.
Purpose of the Study:
- To evaluate the long-term (8-year) impact of technology-enabled interventions on the rate, actionability, and resolution of radiologist recommendations for additional imaging (RAIs).
Main Methods:
- A retrospective cohort study analyzed radiology reports from two tertiary hospitals (study and control sites) between January 2015 and December 2022.
- The study site implemented quality improvement interventions: radiologist education, electronic communication tools for RAI tracking, and performance reports.
- Statistical analyses included linear regression for RAI rate trends and mixed-effects logistic regression for intervention impact, with Fisher exact tests for actionability and resolution.
Main Results:
- The RAI rate at the study site decreased by 44% (from 10% to 5.6%), while remaining unchanged at the control site (around 11%).
- RAI rates declined progressively with each successive intervention at the study site (P < .001).
- Recommendation actionability increased 7.6-fold at the study site (5.6% to 42.3%), and actionable RAIs were resolved more frequently (84.7% vs 59.6%).
Conclusions:
- Multifaceted, technology-enabled interventions effectively optimize radiologist recommendations for additional imaging (RAIs).
- These interventions significantly reduce RAI rates, enhance recommendation actionability, and improve the resolution of actionable RAIs.
- The findings support the implementation of such strategies to improve imaging utilization and diagnostic accuracy.
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