title: Frequency of recommendations for additional imaging in diagnostic ultrasound examinations: Evaluation of radiologist, technologist, and other examination-related factors.
abstract: OBJECTIVE
  Our aim in this study was to evaluate the effect of the radiologist, technologist, and other examination-related factors on the frequency of recommendations for additional imaging (RAI) during sonographic (US) interpretation.
  
  
  METHODS
  We retrospectively reviewed 719 US reports from a single academic medical center for the presence of RAI. All studies had been interpreted by one of three abdominal radiologists. Examinations were performed at an outpatient radiology facility with no onsite radiologist (n = 299) or at an inpatient emergency department or hospital-based outpatient setting that had an onsite radiologist (n = 420). Possible associations between the frequency of RAI and the presence of an onsite radiologist, location of the examination, body part or region imaged, patient age, technologist performing the exam, and radiologist reading the exam were evaluated.
  
  
  RESULTS
  There were significant differences between each pair of radiologists in terms of overall frequency of RAI (p < 0.001) (radiologist 1: 12.0% [22/184]; radiologist 2: 21.6% [78/361]; and radiologist 3: 45.5% [79/174]). In addition, there were statistically significant differences in the frequency of RAI among studies scanned by the 10 different US technologists (13.6%-40.0%, p = 0.03). However, other factors such as patient age, patient sex, US unit, patient location, and radiologist location were not associated with the frequency of RAI (p = 0.15-0.93).
  
  
  CONCLUSIONS
  The individual radiologist and technologist influenced the frequency of RAI for US examinations, whereas other examination-related factors did not. The observed substantial variability in RAI between radiologists and technologists warrants further study, with consideration of strategies to optimize RAI within US reports.
authors.affiliation: Department of Radiology, NYU Langone Medical Center, 550 First Avenue, New York, NY, 10016.
authors.forename: Nathaniel E
authors.initials: NE
authors.lastname: Margolis
authors.affiliation: Department of Radiology, NYU Langone Medical Center, 550 First Avenue, New York, NY, 10016.
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Rosenkrantz
authors.affiliation: Department of Radiology, NYU Langone Medical Center, 550 First Avenue, New York, NY, 10016.
authors.forename: James S
authors.initials: JS
authors.lastname: Babb
authors.affiliation: Department of Radiology, NYU Langone Medical Center, 550 First Avenue, New York, NY, 10016.
authors.forename: Michael
authors.initials: M
authors.lastname: Macari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014463:Ultrasonography / Q000706:statistics & numerical data*
keywords: incidental findings; off-site radiologist; recommendations for additional imaging; technologist; teleradiology; ultrasonography