Impact of detecting potentially serious incidental findings during multi-modal imaging [version 3; referees: 2 approved, 1 approved with reservations]
Wellcome open research(2018)
摘要
textabstractBackground: There are limited data on the impact of feedback of incidental
findings (IFs) from research imaging. We evaluated the impact of UK
Biobank’s protocol for handling potentially serious IFs in a multi-modal
imaging study of 100,000 participants (radiographer ‘flagging’ with
radiologist confirmation of potentially serious IFs) compared with systematic
radiologist review of all images.
Methods: Brain, cardiac and body magnetic resonance, and dual-energy
x-ray absorptiometry scans from the first 1000 imaged UK Biobank
participants were independently assessed for potentially serious IFs using
both protocols. We surveyed participants with potentially serious IFs and
their GPs up to six months after imaging to determine subsequent clinical
assessments, final diagnoses, emotional, financial and work or activity
impacts.
Results: Compared to systematic radiologist review, radiographer flagging
resulted in substantially fewer participants with potentially serious IFs
(179/1000 [17.9%] versus 18/1000 [1.8%]) and a higher proportion with
serious final diagnoses (21/179 [11.7%] versus 5/18 [27.8%]).
Radiographer flagging missed 16/21 serious final diagnoses (i.e., false
negatives), while systematic radiologist review generated large numbers of
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