Managing Incidental Findings

Valeria Makeeva, MD; Kirsten Schofield, MS; Melissa Davis, MBA, MD; Nadja Kadom, MD


Appl Radiol. 2021;50(6):22-26. 

In This Article

Accessing Evidence-based Guidance

Some strategies focus on making evidence-based guidance accessible to radiologists when they are issuing their reports. Low-fidelity strategies using either no or simple IT tools, fall into three categories: physical or verbal reminders, electronic references, and enhanced reporting templates.[26] Radiologists may access guidance documents as abbreviated hard copies their workstation. They may learn about guidance documents during monthly case conferences or through designated "guideline champions" who work with clinical teams to sustain guidance-based incidental findings management.[27–29] Electronic guideline references may also be embedded within reporting systems, where radiologists can easily access and review them.[30–33] In "enhanced radiology reporting," the report includes more detail, such as the probability that a lung nodule is cancer, and a reference to the follow-up recommendation.[34,35]

Although these simple strategies are an improvement over baseline, they typically yield inconsistent results owing to their reliance on individual radiologist practices. It is conceivable that practice standardization across the radiology enterprise using more sophisticated technology would be more successful.[26,36–38]