ArticleJournal of hospital medicine2019
Follow Up of Incidental High-Risk Pulmonary Nodules on Computed Tomography Pulmonary Angiography at Care Transitions.
Article in Journal of hospital medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of natural language processing applied to radiology reports.BMC medical informatics and decision making · 2021Pooled it
- Development of a Pulmonary Nodule Service and Clinical Pathway: A Pragmatic Approach Addressing an Unmet Need.Diagnostics (Basel, Switzerland) · 2025Article
- Comparison of computed tomography and guided bronchoscopy in the diagnosis of pulmonary nodules: A systematic review and meta-analysis.Open medicine (Warsaw, Poland) · 2025Article
- Evaluation of GPT-4 ability to identify and generate patient instructions for actionable incidental radiology findings.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Incidental pulmonary nodule management in Canada: exploring current state through a narrative literature review and expert interviews.Journal of thoracic disease · 2024Review
- Natural Language Processing for the Identification of Incidental Lung Nodules in Computed Tomography Reports: A Quality Control Tool.JCO global oncology · 2023Article
- Closing the loop: automatically identifying abnormal imaging results in scanned documents.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- RADAR: A Closed-Loop Quality Improvement Initiative Leveraging A Safety Net Model for Incidental Pulmonary Nodule Management.Joint Commission journal on quality and patient safety · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundComputed tomography pulmonary angiography (CTPA) detects incidental findings that require follow-up. In just over 50% of cases, those incidental findings are pulmonary nodules. Fleischner guidelines recommend that patients with nodules that have a high risk of malignancy should undergo CT follow-up within 3-12 months.
objectiveWe examined the proportion of patients with pulmonary nodules requiring follow up who received repeat imaging within six weeks of the time frame recommended by the radiologist.
designThis retrospective cohort study included all patients who underwent CTPA in the emergency department and inpatient settings at three teaching hospitals in Toronto, Canada between September 1, 2014, and August 31, 2015. Natural language processing software was applied to a linked radiology information system to identify all CTPAs that contained pulmonary nodules. Using manual review and prespecified exclusion criteria, we generated a cohort with possible new lung malignancy eligible for follow-up imaging; then we reviewed available health records to determine whether follow-up had occurred.
resultsOf the 1,910 CTPAs performed over the study period, 674 (35.3%) contained pulmonary nodules. Of the 259 patients with new nodules eligible for follow-up imaging, 65 received an explicit suggestion for follow-up by radiology (25.1%). Of these 65 patients, 35 (53.8%) did not receive repeat imaging within the recommended time frame. Explicit mention that follow-up was required in the discharge summary (P = .03), attending an outpatient follow-up visit (P < .001), and younger age (P = .03) were associated with receiving timely follow-up imaging.
conclusionsOver 50% of patients with new high-risk pulmonary nodules detected incidentally on CTPA did not receive timely follow-up imaging.
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