A practical approach to incidental findings in neuroimaging research

J. M. Shoemaker, M. T. Holdsworth, C. Aine, V. D. Calhoun, R. De La Garza, Sarah Feldstein Ewing, R. Hayek, A. R. Mayer, K. A. Kiehl, L. E. Petree, P. Sanjuan, A. Scott, J. Stephen, J. P. Phillips

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Objective: We describe the systematic approach to incidental findings (IFs) used at the Mind Research Network (MRN) where all MRI scans receive neuroradiologist interpretation and participants are provided results. Methods: From 2004 to 2011, 8,545 MRI scans were acquired by 45 researchers. As mandated by MRN's external institutional review board, all structural sequences were evaluated by a clinica neuroradiologist who generated a report that included recommendations for referral if indicated. Investigators received a copy of their participants' reports, which were also mailed to participants unless they specifically declined. To better understand the impact of the radiology review process, a financial analysis was completed in addition to a follow-up phone survey to characterize participant perceptions regarding receiving their MRI scan results. Results: The radiologist identified IFs in 34% of the 4,447 participants. Of those with IFs (n = 1,518), the radiologist recommended urgent or immediate referral for 2.5% and routine referra for 17%. For 80.5%, no referral was recommended. Estimated annual cost for this approach ncluding support for the neuroradiologist, medical director, and ancillary staff is approximately $60,000 or $24/scan. The results of the retrospective phone survey showed that 92% of particpants appreciated receiving their MRI report, and the majority stated it increased their likelihood of volunteering for future studies. Conclusions: Addressing IFs in a cost-effective and consistent manner is possible by adopting a policy that provides neuroradiology interpretation and offers participant assistance with clinica follow-up when necessary. Our experience suggests that an ethical, institution-wide approach to IFs can be implemented with minimal investigator burden.

Original languageEnglish (US)
Pages (from-to)2123-2127
Number of pages5
JournalNeurology
Volume77
Issue number24
DOIs
StatePublished - Dec 13 2011
Externally publishedYes

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Incidental Findings
Neuroimaging
Research
Referral and Consultation
Research Personnel
Magnetic Resonance Imaging
Physician Executives
Costs and Cost Analysis
Research Ethics Committees
Radiology
Phone
Costs

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)

Cite this

Shoemaker, J. M., Holdsworth, M. T., Aine, C., Calhoun, V. D., De La Garza, R., Feldstein Ewing, S., ... Phillips, J. P. (2011). A practical approach to incidental findings in neuroimaging research. Neurology, 77(24), 2123-2127. https://doi.org/10.1212/WNL.0b013e31823d7687

A practical approach to incidental findings in neuroimaging research. / Shoemaker, J. M.; Holdsworth, M. T.; Aine, C.; Calhoun, V. D.; De La Garza, R.; Feldstein Ewing, Sarah; Hayek, R.; Mayer, A. R.; Kiehl, K. A.; Petree, L. E.; Sanjuan, P.; Scott, A.; Stephen, J.; Phillips, J. P.

In: Neurology, Vol. 77, No. 24, 13.12.2011, p. 2123-2127.

Research output: Contribution to journalArticle

Shoemaker, JM, Holdsworth, MT, Aine, C, Calhoun, VD, De La Garza, R, Feldstein Ewing, S, Hayek, R, Mayer, AR, Kiehl, KA, Petree, LE, Sanjuan, P, Scott, A, Stephen, J & Phillips, JP 2011, 'A practical approach to incidental findings in neuroimaging research', Neurology, vol. 77, no. 24, pp. 2123-2127. https://doi.org/10.1212/WNL.0b013e31823d7687
Shoemaker JM, Holdsworth MT, Aine C, Calhoun VD, De La Garza R, Feldstein Ewing S et al. A practical approach to incidental findings in neuroimaging research. Neurology. 2011 Dec 13;77(24):2123-2127. https://doi.org/10.1212/WNL.0b013e31823d7687
Shoemaker, J. M. ; Holdsworth, M. T. ; Aine, C. ; Calhoun, V. D. ; De La Garza, R. ; Feldstein Ewing, Sarah ; Hayek, R. ; Mayer, A. R. ; Kiehl, K. A. ; Petree, L. E. ; Sanjuan, P. ; Scott, A. ; Stephen, J. ; Phillips, J. P. / A practical approach to incidental findings in neuroimaging research. In: Neurology. 2011 ; Vol. 77, No. 24. pp. 2123-2127.
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abstract = "Objective: We describe the systematic approach to incidental findings (IFs) used at the Mind Research Network (MRN) where all MRI scans receive neuroradiologist interpretation and participants are provided results. Methods: From 2004 to 2011, 8,545 MRI scans were acquired by 45 researchers. As mandated by MRN's external institutional review board, all structural sequences were evaluated by a clinica neuroradiologist who generated a report that included recommendations for referral if indicated. Investigators received a copy of their participants' reports, which were also mailed to participants unless they specifically declined. To better understand the impact of the radiology review process, a financial analysis was completed in addition to a follow-up phone survey to characterize participant perceptions regarding receiving their MRI scan results. Results: The radiologist identified IFs in 34{\%} of the 4,447 participants. Of those with IFs (n = 1,518), the radiologist recommended urgent or immediate referral for 2.5{\%} and routine referra for 17{\%}. For 80.5{\%}, no referral was recommended. Estimated annual cost for this approach ncluding support for the neuroradiologist, medical director, and ancillary staff is approximately $60,000 or $24/scan. The results of the retrospective phone survey showed that 92{\%} of particpants appreciated receiving their MRI report, and the majority stated it increased their likelihood of volunteering for future studies. Conclusions: Addressing IFs in a cost-effective and consistent manner is possible by adopting a policy that provides neuroradiology interpretation and offers participant assistance with clinica follow-up when necessary. Our experience suggests that an ethical, institution-wide approach to IFs can be implemented with minimal investigator burden.",
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AU - Feldstein Ewing, Sarah

AU - Hayek, R.

AU - Mayer, A. R.

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AU - Petree, L. E.

AU - Sanjuan, P.

AU - Scott, A.

AU - Stephen, J.

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