Objective
Although recommendations for additional imaging are common in radiology reports, completion of follow-up imaging does not always occur, which could reflect disagreement between radiologist and referring provider. We assessed how frequently referring providers agree with radiologists' follow-up recommendations, reasons for disagreement, and factors associated with radiologist-referring provider agreement.Methods
This Institutional Review Board-exempt, retrospective study was performed at a large academic center. A PACS-integrated tool allowed radiologists to send follow-up imaging recommendations to referring providers, who used the tool to document agreement or disagreement with recommendations. The study included recommendations sent for outpatients between 10/21/2019-10/31/2022. Multivariable logistic regression analysis was performed to identify patient, radiologist, and imaging examination factors associated with radiologist-referring provider agreement.Results
Of the 9,406 recommendations meeting inclusion criteria, 8,331 (88.6%) resulted in agreement. The most common reason for disagreement was that the recommendation was considered not clinically relevant (44.5%, 478/1,075). The following factors were associated with low rates of agreement: referring provider being a surgeon (Odds Ratio [OR] 0.73, p<0.001), or recommendation for follow-up nuclear imaging (OR 0.64, p=0.012). The odds of agreement were higher for recommendations made by thoracic radiologists (OR 1.41, p=0.002) and for recommendations with longer follow-up time frames (weeks) (OR 1.03, p<0.001). Patient race, ethnicity, insurance type, and living in a socioeconomically disadvantaged neighborhood were not significantly associated with radiologist-referring provider agreement.Discussion
Referring providers frequently agree with follow-up imaging recommendations made by radiologists for outpatients, and patient demographics and socioeconomic factors do not appear to significantly impact radiologist-referring provider agreement.
