Three radiologists from University Medical Center Groningen in the Netherlands conducted a retrospective study of 4,696 consecutive second-opinion reports of external imaging exams authorized by subspecialty radiologists at a tertiary care institution between 1 January and 31 December 2018.
The researchers found 537 (11.4%) were not read by a clinician, with the highest modality being ultrasound (20/32, 62.5%), and the highest subspecialty being interventional radiology (12/23, 52.2%).
The following variables remained significantly and independently associated with the second-opinion report not being read:
- Inpatient status
- Sonography as the imaging modality
- Surgery or neurology as the specialty of the requesting clinician
- Interventional radiology as the subspecialty of the radiologist who authorized the second-opinion report
The 537 unread second-opinion reports could cost as much as 53,700 euros, given that the National Healthcare Authority of the Netherlands allows up to 100 euros to be charged for each second-opinion reading.
"Although these numbers appear modest, they pertain to a single institution during a one-year time period," wrote first author Dr. Sabine Heinz.
Cumulative nationwide figures would raise these totals "possibly substantially" and the number of unread second-opinion reports will likely increase "given the projected rise in future second-opinion requests," she added.
Additionally, the 11.4% unread rate is likely an underestimation because opening the report in the electronic patient file system does not necessarily mean the clinician actually read the report, the researchers concluded.
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