A systematic review of studies carried out in the U.S. has found that, depending on the study, physicians failed to follow up on as many as 36 percent of radiology reports for patients attended by general practitioners, or in clinics or hospital emergency departments.
Researchers from the University of New South Wales Medicine in Australia examined 19 studies that quantified the failure to follow up laboratory and radiology tests for patients in ambulatory settings. The results, published in the Journal of General Internal Medicine, demonstrated a wide discrepancy in the rates of missed laboratory test results and radiology reports.
For example, rates of missed abnormal radiology reports ranged from 1 percent to 11 percent for patients with suspected malignancies. Two studies on mammograms reported no evidence of follow-up in 11 percent of abnormal mammograms in one study, and almost 36 percent in the second study. In the case of missed lab reports, the extent of the problem ranged from 6.8 percent to 62 percent.
The impact of the missed test results on patient outcomes was reported in seven of the studies, and included missed cancer diagnoses.
"Failure to follow-up test results for patients is a critical safety issue which requires urgent attention," lead researcher Joanne Callen, an associate professor at UNSW Medicine, said in an announcement. "Without knowledge of the size and effect of the problem, many clinicians may underestimate its extent and consequences."
The researchers suggested solutions to the issue of missed follow-ups should include:
- The implementation of explicit policies and procedures for test follow-up.
- Evaluation of information and communication technology to ensure that systems enhance the test management process.
- An "interdisciplinary" approach to result follow-up and patient notification, meaning that physicians, nurses and radiology/laboratory staff should all be involved.