When radiologists initiate verbal communication, patients are more likely to receive recommended imaging follow-up

Radiologists can increase the likelihood that patients receive outpatient imaging follow-up for findings indeterminate for malignancy by initiating verbal communication, according to a new study published by the Journal of the American College of Radiology.

“Unfortunately, poor communication between radiologists and referring providers represents a common source of error and remains an area for improvement,” wrote lead author Geraldine J. Liao, MD, with the department of radiology at the University of Washington in Seattle, and colleagues. “In particular, incomplete notification of findings representing possible cancer (eg, solid renal mass) can harm patients through delayed or missed cancer diagnoses.”

To test the effectiveness of radiologist-initiated verbal communication, Liao et al. analyzed data from more than 700 abdominal CT, MRI and ultrasound studies containing codes corresponding to imaging findings indeterminate for malignancy performed between July 2013 and January 2014. Using multivariate logistic regression, the team determined that 62 percent of those patients received the appropriate outpatient imaging follow-up. Radiologists initiated verbal communication with referring physicians of just 4.8 percent of the patients studied, but such communication was associated with a higher likelihood of the patient receiving relevant imaging follow-up.

“This association may be driven by multiple factors, including heightened radiologist concern about the potential significance of certain imaging findings over others, heightened referring provider concern due to radiologist-initiated verbal communication, reduced communication error through verbal delivery of results rather than reliance on radiology report review, or a combination thereof,” the authors wrote.

Liao and colleagues added that verbal communication “may not be feasible in all instances,” but it should at least be considered for any cases where the finding is indeterminate for malignancy or suspicious for malignancy.

The data also determined that the patient having a previous cancer diagnosis is associated with an increased likelihood they will receive relevant imaging follow-up, a finding viewed as “not surprising.”

The authors did note that their study had limitations. For instance, they couldn’t account for patients who may have received the relevant imaging follow-up outside of the United States. And the radiologists may have communicated verbally without documenting it, though that seems “unlikely given a strong institution culture of documenting communication.”