Provider, Patient Preferences for Communicating CT Lung Screening Results Vary

Lisa Rapaport

August 13, 2021

(Reuters Health) — Even though most providers and patients are comfortable with having radiologists communicate CT lung screening results, their preferences vary and may require an individualized approach to communication, a new study suggests.

To assess viewpoints surrounding this type of communication, researchers examined survey responses from 47 referring providers and 140 patients undergoing annual lung cancer screening with low-dose CT. The surveys were administered in 2016 and 2017, before a 2021 federal law went into effect that requires healthcare providers to give patients access without charge to all the health information in their electronic medical records "without delay."

In the surveys, with normal CT results, 74% of providers agreed and 12% disagreed that the radiologist should discuss findings over the phone with the provider before reviewing images with patients. All of the providers, however, said they were comfortable with radiologists giving patients normal results without discussing it with them first.

With abnormal CT results, 81% of providers agreed and 19% disagreed that the radiologist should discuss findings over the phone with the provider before going over images with patients. All but four providers who agreed that a prior phone call was preferable also said they were comfortable with radiologists giving results to patients without a call first.

"For both providers and patients, there is generally a sense of wanting results to be part of a dialogue — in which the provider addresses the patient's main concerns and questions, and prepares one for next steps if the results are abnormal," said Dr. Stella Kang, an associate professor in the Department of Radiology and Department of Population Health at New York University Langone Health in New York City.

"That might feel most comfortable when a therapeutic relationship is established already, or when patients are informed about the role of radiologists in screening and explaining next steps," Dr. Kang, who wasn't involved in the study, said by email.

Patients offered a different perspective. For any type of imaging, patients most often said they wanted to receive CT results from their referring provider (51%), but some of them said they would like results from the radiologist (25%) or in writing (23%).

For lung cancer screening specifically, the majority of patients (74%) were willing to receive normal or abnormal results from the radiologist and most (74%) also wanted to see the CT images.

One limitation of the study is its low response rates. The provider response rate was 24% (47 out of 192) and the patient response rate was 54% (140 out of 258).

Another limitation is that it was done at a single academic center and results might not be generalizable to other settings, the study team notes in the Journal of the American College of Radiology. Lead study author Dr. Joanna Escalon of New York-Presbyterian/Weill Cornell Medicine in New York City wasn't immediately available for comment.

Survey-based studies like this can also be difficult to interpret and apply to individual practices, particularly because participants may not be representative of all providers and patients, said Dr. A.J. Gunn, an associate professor of radiology at the University of Alabama at Birmingham who wasn't involved in the study.

"One of the key points may be that an 'all of the above' approach to communicating the results of a radiology examination is best," Dr. Gunn said by email. "In this way, patients and referring physicians could select the manner that most suits their needs and expectations, whether that be through traditional delivery of the report via the referring physician, leveraging patient portals to increase access, or direct communication with the interpreting radiologist."

SOURCE: Journal of the American College of Radiology, online July 9, 2021.