why hospitals must do more to address incidental findings

While the term “incidental finding” may sound like something found in a police report, it is actually a very significant medical term found in a patient chart. It essentially describes an unintentional yet important discovery made during an imaging test — CT scan, X-ray, MRI, etc. — undertaken for a completely unrelated purpose.

To illustrate, consider a chest X-ray for broken ribs uncovering a spot on the lungs or an MRI of the head after a concussion revealing a brain tumor.

While one would like to think that incidental findings are a real stroke of luck for both patients and providers alike, giving them precious time to start treatment, studies have actually shown that a large percentage aren’t noted in patient charts, reported to primary care physicians or even reported to the patients themselves.

Furthermore, these studies have determined that the places where this type of medical mistake is most likely to occur are emergency rooms and trauma centers, two hectic environments that aren’t typically set up to provide follow-up care.

If this seems hard to believe, consider a 2013 study in the Annals of Emergency Medicine, which made some rather shocking discoveries concerning how incidental findings were being handled in emergency rooms across the nation.

The study found the following rates of incidental findings among a cross-section of ER department radiology records:

  • 34 percent of incidental findings among trauma patients undergoing CT scans.
  • 31 percent of incidental findings among patients undergoing abdominal CT scans.
  • 14.2 percent of incidental findings among patients undergoing screening for lung cancer.
  • 7.7 percent of incidental findings among patients undergoing screening for artery disease.

Despite these numbers, the study revealed that only 4.5 percent of ER department radiology reports made recommendations to follow up with the patient on the incidental findings and, of these, half were actually noted in the patient discharge instructions.

In our next post, we’ll see what some of the nation’s leading medical facilities are doing to help ensure that important information on incidental findings is properly relayed to patients.

Those victimized by medical negligence in any form can seek justice for the harm that they or a family member has endured. Consider speaking with an experienced legal professional to learn more.

Source: The Wall Street Journal, “Surprise results in medical tests draw new focus,” Laura Landro, Nov. 10, 2014

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