TY - JOUR
T1 - A Secondary Analysis to Identify Patient-Centered Outcomes in the ACR's Appropriateness Criteria
AU - PROD Research Group
AU - Thompson, Matthew J.
AU - Hardy, Victoria
AU - Zigman Suchsland, Monica
AU - Devine, Beth
AU - Kurth, David
AU - Chou, Roger
AU - Haines, G. Rebecca
AU - Jarvik, Jeffrey G.
N1 - Publisher Copyright:
© 2019 American College of Radiology
PY - 2019/12
Y1 - 2019/12
N2 - Context: There is a growing body of literature indicating imaging testing can affect patients cognitively, socially, behaviorally, and emotionally. The extent to which these patient-centered outcomes (PCOs) are reported in the imaging literature is unclear. Identifying PCOs may facilitate shared decision making around imaging testing. Objective: To identify PCOs across a spectrum of clinical topics included in the ACR's Appropriateness Criteria (AC). Methods: We systematically reviewed AC evidence tables for eligible articles of studies conducted in any clinical setting in high-income countries. Included studies reported PCOs occurring as a direct or indirect result of an imaging test performed for any reason (eg, diagnosis, screening, surveillance, or staging). PCOs and the methods used to measure them were extracted through a secondary analysis and descriptive synthesis. Results: Our search identified 89 articles that reported outcomes of radiation exposure (n = 37), downstream testing (n = 20), complications (n = 19), incidental findings (n = 10), quality of life (n = 7), physical discomfort (n = 5), patient values and experiences (n = 4), patient financial and time costs (n = 4), psychosocial outcomes (n = 4), and test duration (n = 2). These outcomes were rarely reported from the patient perspective and were measured using a range of standardized or validated and nonstandardized methods. Conclusions: We identified few PCOs incorporated in the AC. Our findings reflect the historical emphasis of diagnostic research on accuracy, clinical utility, and selected outcomes (eg, adverse events). As radiology moves to a more patient-centered approach, it will be important to measure PCOs reported directly from patients.
AB - Context: There is a growing body of literature indicating imaging testing can affect patients cognitively, socially, behaviorally, and emotionally. The extent to which these patient-centered outcomes (PCOs) are reported in the imaging literature is unclear. Identifying PCOs may facilitate shared decision making around imaging testing. Objective: To identify PCOs across a spectrum of clinical topics included in the ACR's Appropriateness Criteria (AC). Methods: We systematically reviewed AC evidence tables for eligible articles of studies conducted in any clinical setting in high-income countries. Included studies reported PCOs occurring as a direct or indirect result of an imaging test performed for any reason (eg, diagnosis, screening, surveillance, or staging). PCOs and the methods used to measure them were extracted through a secondary analysis and descriptive synthesis. Results: Our search identified 89 articles that reported outcomes of radiation exposure (n = 37), downstream testing (n = 20), complications (n = 19), incidental findings (n = 10), quality of life (n = 7), physical discomfort (n = 5), patient values and experiences (n = 4), patient financial and time costs (n = 4), psychosocial outcomes (n = 4), and test duration (n = 2). These outcomes were rarely reported from the patient perspective and were measured using a range of standardized or validated and nonstandardized methods. Conclusions: We identified few PCOs incorporated in the AC. Our findings reflect the historical emphasis of diagnostic research on accuracy, clinical utility, and selected outcomes (eg, adverse events). As radiology moves to a more patient-centered approach, it will be important to measure PCOs reported directly from patients.
KW - Appropriateness criteria
KW - imaging
KW - patient centered
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U2 - 10.1016/j.jacr.2019.05.016
DO - 10.1016/j.jacr.2019.05.016
M3 - Article
C2 - 31173747
AN - SCOPUS:85075203670
SN - 1546-1440
VL - 16
SP - 1645
EP - 1655
JO - Journal of the American College of Radiology
JF - Journal of the American College of Radiology
IS - 12
ER -