Focal XXXX : assessing variation in radiologists' management recommendations.

@entity1 @entity788 @entity660 @entity730 @entity45
PURPOSE: To estimate the prevalence of focal @entity660 (FCPLs) among @entity1 undergoing computed tomographic (CT) or magnetic resonance (MR) imaging at one institution and to examine any variation in radiologists' recommendation practice pattern with regards to FCPLs. MATERIALS AND METHODS: Institutional review board approval was obtained for this retrospective HIPPA-compliant study. The requirement to obtain informed consent was waived. A cohort of @entity1 with FCPLs was identified from radiology reports by using natural language processing. @entity1 -specific (ie, age, sex, symptoms, history of @entity788 ), radiologist-specific (ie, years of experience, area of expertise), and FCPL-specific (ie, size, location, septation, @entity730 , mural nodularity, pancreatic duct involvement, and presence of @entity45 ) variables were obtained. The outcome measure was whether a follow-up study was recommended. A logistic regression model was used to identify relative recommendation rates after controlling for key explanatory variables. RESULTS: Between January 1 and December 31, 2009, a total of 1067 FCPLs were identified in 765 @entity1 . Prevalence rates ranged from 2.2% at CT to 15.9% at MR imaging. Radiologists recommended a follow-up imaging study in 23.7% of cases of a FCPL. A 2.8-fold difference in the rate of recommendation of further imaging existed across radiologists after controlling for explanatory variables such as lesion-, radiologist-, and @entity1 -specific characteristics. A history of @entity788 was associated with a nearly two-fold decrease in recommending further imaging. CONCLUSION: FCPLs are common, and nearly one-quarter of radiology reports recommend at least one follow-up imaging study. Significant variation exists in the rate of recommendation for further imaging studies by radiologists, even after controlling for key explanatory variables.
