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Repeat Imaging Rates for Office-Based Imaging Studies Interpreted by Nonphysician Practitioners Compared With
Eric W Christensen1, Alexandra R Drake2, Stella K Kang3
1Research Director, Harvey L. Neiman Health Policy Institute, Reston, Virginia.
Journal of the American College of Radiology : JACR
|September 17, 2025
Summary
Repeat imaging studies are more common when interpreted by a nonphysician practitioner (NPP) compared to a radiologist, potentially leading to unnecessary care. This finding highlights the importance of careful interpretation in medical imaging.
Area of Science:
- Radiology and Medical Imaging
- Health Services Research
- Healthcare Quality Improvement
Background:
- Differences in imaging interpretation can lead to variations in patient care and resource utilization.
- Assessing repeat imaging rates is crucial for identifying potential inefficiencies and unnecessary healthcare expenditures.
Purpose of the Study:
- To compare the rates of repeat imaging within 90 days between studies interpreted by nonphysician practitioners (NPPs) and radiologists.
- To investigate whether the interpreter type influences the likelihood of repeat imaging across different modalities and anatomic regions.
Main Methods:
- A retrospective analysis of Medicare fee-for-service beneficiaries from 2013-2022 was conducted.
- Imaging studies (radiography, ultrasound, MRI) with at least 30 repeat studies within 90 days were included.
- Logistic regression adjusted for patient and community factors was used to compare repeat imaging likelihood.
Main Results:
- Over 1.39 million imaging studies were analyzed, with 12.5% undergoing repeat imaging.
- Repeat imaging rates were consistently higher for NPP-interpreted studies across radiography, ultrasound, and MRI.
- Adjusted odds ratios for repeat imaging were significantly higher for NPP interpretations, ranging from 1.35 for radiography to 2.56 for MRI.
Conclusions:
- Imaging studies interpreted by NPPs demonstrate a higher likelihood of repeat imaging compared to those interpreted by radiologists.
- These findings suggest potential for excess reimaging, raising concerns about unnecessary healthcare utilization and costs.
- The study underscores the need for standardized interpretation protocols and quality oversight in medical imaging.
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