Determining Adherence to Follow-up Imaging Recommendations

Radiology reports often contain follow-up imaging recommendations. However, these recommendations are not always followed up by referring physicians and patients. Failure to comply in a timely manner can lead to delayed treatment, poor patient outcomes, unnecessary testing, lost revenue, and legal liability. Therefore, the primary objective of this research was to determine adherence rates to follow-up recommendations. We extracted radiology examination–related data, including report text, for examinations performed between January 1, 2010, and February 28, 2017, from the radiology information system at an academic institution. The data set contained 2,972,164 examinations. The first 6 years were used as the period during which a follow-up recommendation was to be detected, allowing for a maximum of 14 months for a follow-up examination to be performed. At least one recommendation for follow-up imaging was present in 10.6% of radiology reports. Overall, the follow-up imaging adherence rate was 58.14%. Mammography had the highest follow-up adherence rate at 69.03%, followed by MRI at 67.54%. Of the modalities, nuclear medicine had the lowest adherence rate at 37.93%. This study confirms that follow-up imaging adherence rates are inherently low and vary by modality and that appropriate interventions may be needed to improve compliance to follow-up imaging recommendations.