The prevalence and implications of incidental findings on ED abdominal CT scans***
Presented at the Society of General Internal Medicine (SGIM) Regional Meeting March 31, 2000 and the SGIM National Meeting May 4, 2000.
Affiliations
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
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Fig. 1
Results of review of CT scan reports for incidental findings. *Reports eliminated if either blinded reviewer felt that an alternative diagnosis (aside from nephrolithiasis) was indicated by the official CT scan report.
Abstract
We reviewed reports from 321 consecutive emergency department (ED) noncontrast, helical “renal stone” abdominal CT scans obtained at a single medical center between April 1996 to June 1997 for incidental findings. Incidental findings were common (45% of scans), and approximately half were rated of “moderate” or “serious” concern by 2 independent reviewers (kappa = 0.72). ED records indicated that only 21% of incidental findings were documented, and only 11 (18%) of cases with findings of “moderate/severe” concern had evidence of follow-up on hospital chart review. Although work-up of these 11 cases did not yield any serious diagnoses, many potentially serious incidental findings without follow-up remain worrisome. (Am J Emerg Med 2001;19:479-481. Copyright © 2001 by W.B. Saunders Company)
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*Address reprint requests to Michael J. Barry, MD, Chief, General Medicine Unit, Massachusetts General Hospital, 50 Staniford Street, 9th floor, Boston, MA 02114. E-mail: mbarry@partners.org
**0735-6757/01/1906-0005$35.00/0
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