title: Incidental computer tomography radiologic findings through research participation in the North Texas Healthy Heart Study.
abstract: BACKGROUND
  Although variation exists in the classification and practice of managing clinical findings in research, emerging views suggest that researchers bear some responsibility in the management of incidental findings. This study contributes to the documentation of the population characteristics and prevalence of medical findings incidental to research participation, specifically findings related to coronary calcium scores and computed tomography (CT) scans that investigated cardiovascular disparities in an asymptomatic population.
  
  
  METHODS
  A total of 571 asymptomatic adult participants were recruited in the North Texas Healthy Heart Study. Participants completed a 16-slice CT scan of the heart and abdomen. Findings of radiology reports and 3 years of follow-up documentation were reviewed.
  
  
  RESULTS
  A total of 246 clinically apparent findings were identified in 169 asymptomatic participants (32.9% of participants who completed a CT scan). Another 245 participants (48%) had findings of unknown significance, a total of 307 findings. At least 4 cases in this study led to a clinically significant intervention.
  
  
  CONCLUSIONS
  Although CT scans were completed for research purposes, study procedures resulted in the diagnosis and treatment of individuals who were previously asymptomatic. Potential clinical benefits in imaging research are moderated by considerations regarding possible harm and costs resulting from uncertain findings and the use of CT scans for nonclinical purposes. The continued development of protocols for the handling of incidental findings in research and the establishment of guidelines are needed to ensure that research procedures mirror the best interests of participants.
authors.affiliation: the Primary Care Research Center/Texas Prevention Institute, the Department of Family Medicine, and the Department of Family and Community Medicine, University of Kentucky College of Medicine, Lexington.
authors.forename: Anna
authors.initials: A
authors.lastname: Espinoza
authors.forename: Kendra
authors.initials: K
authors.lastname: Malone
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Balyakina
authors.forename: Kimberly G
authors.initials: KG
authors.lastname: Fulda
authors.forename: Roberto
authors.initials: R
authors.lastname: Cardarelli
mesh_terms: D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006805:Human Experimentation / Q000706:statistics & numerical data*; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013781:Texas; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D061205:Vascular Calcification / Q000000981:diagnostic imaging*
keywords: Computed Tomography; Incidental Findings; Medical Ethics; Practice-based Research Networks; Research Subjects