title: Incidentally detected lung nodules: clinical predictors of adherence to Fleischner Society surveillance guidelines.
abstract: OBJECTIVE
  The objective of this study was to determine adherence to incidentally detected lung nodule computed tomographic (CT) surveillance recommendations and identify demographic and clinical factors that increase the likelihood of CT surveillance.
  
  
  METHODS
  A total of 419 patients with incidentally detected lung nodules were included. Recorded data included patient demographic, radiologic, and clinical characteristics and outcomes at a 4-year follow-up. Multivariate logistic regression models determined the factors associated with likelihood of recommended CT surveillance.
  
  
  RESULTS
  At least 1 recommended surveillance chest CT was performed on 48% of the patients (148/310). Computed tomographic result communication to the patient (odds ratio [OR], 2.2; P = 0.006; confidence interval [CI], 1.3-4.0) or to the referring physician (OR, 2.8; P = 0.001; CI, 1.7-4.5) and recommendation of a specific surveillance time interval (OR, 1.7; P = 0.023; CI, 1.08-2.72) increased the likelihood of surveillance. Other demographic, radiologic, and clinical factors did not influence surveillance.
  
  
  CONCLUSIONS
  Documented physician and patient result communication as well as the recommendation of a specific surveillance time interval increased the likelihood of CT surveillance of incidentally detected lung nodules.
authors.affiliation: From the *Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland; †Divisions of Pulmonary, Critical Care, and Sleep Medicine, ‡Department of Surgical Services, Boston Children's Hospital; §Department of Medicine, ∥Section of Thoracic Imaging, and ¶Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Carole A
authors.initials: CA
authors.lastname: Ridge
authors.forename: Brian D
authors.initials: BD
authors.lastname: Hobbs
authors.forename: Bolanle A
authors.initials: BA
authors.lastname: Bukoye
authors.forename: Mark D
authors.initials: MD
authors.lastname: Aronson
authors.forename: Phillip M
authors.initials: PM
authors.lastname: Boiselle
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Leffler
authors.forename: Scot B
authors.initials: SB
authors.lastname: Sternberg
authors.forename: David H
authors.initials: DH
authors.lastname: Roberts
mesh_terms: D003142:Communication; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D033162:Incidental Findings; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed