New law aimed at addressing incidental findings care gaps missing the mark, radiologists say
A new Pennsylvania law aimed at addressing imaging incidental findings care gaps is missing the mark, local radiologists asserted on Monday.
Keystone State lawmakers first enacted the bill back in 2018, requiring all entities that perform diagnostic imaging to directly notify outpatients of any significant imaging abnormalities. That includes any findings that could cause a prudent person to seek follow-up care within the next three months.
To test whether Act 112 is actually breaking through to consumers, University of Pennsylvania researchers sent notifications to more than 900 volunteers and quizzed them on the legislation. They found that only about 60% of respondents correctly understood the subject, next steps and the process for obtaining their reports, according to an analysis published Saturday in JACR.
“Layperson understanding of information directly and indirectly communicated in Pennsylvania Act 112 is suboptimal, regardless of reading level or presentation,” first author Gregory Mittl, MD, MBA, a radiology resident with the University of Pennsylvania Health System, and colleagues wrote March 13. “New Act 112 language is needed to improve patient understanding, which would ideally be coproduced with Pennsylvania patients, policymakers and other relevant stakeholders.”
Penn researchers developed four separate notifications to send to patients, varying between sixth or 12th grade reading levels, with or without an infographic. They randomly assigned 909 volunteers to receive one of the alerts and later a survey.
Regardless of notification type, 60% of the final study group correctly comprehended all three questions posed, and about half understood that the notifications indirectly conveyed the possibility of abnormal imaging results. “Interestingly,” the authors added, they did not find any clear superiority for one combination of reading level and graphic presentation. About 8 of 10 patients felt worried after viewing Act 112 language, they also found.
“Correct layperson responses to all three questions directly addressed in the Act 112 notification was associated with correctly indirectly inferring that test results were abnormal and with higher levels of worry. This suggests that understanding of the notification is likely to induce anxiety among laypeople, which may be appropriate given the potential need for follow-up,” the study’s authors advised.
You can read more about their findings in the Journal of the American College of Radiology here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.