title: Rethinking Normal: Benefits and Risks of Not Reporting Harmless Incidental Findings.
abstract: The authors explore the benefits and risks of not reporting imaging findings that do not have clinical relevance, with the goal of developing recommendations to reduce their reporting. The authors review the example of incidentally detected, simple renal cysts (Bosniak category I), including medicolegal conditions required for such a shift in reporting practices to be acceptable. The authors propose four potential criteria for not reporting clinically unimportant findings and recommend that these criteria be debated in other contexts, so that they can be refined and implemented.
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: pari@mgh-ita.org.
authors.forename: Pari V
authors.initials: PV
authors.lastname: Pandharipande
authors.affiliation: Department of Radiology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Herts
authors.affiliation: Department of Radiology, NorthShore University Health System, Evanston, Illinois.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Gore
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: William W
authors.initials: WW
authors.lastname: Mayo-Smith
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: H Benjamin
authors.initials: HB
authors.lastname: Harvey
authors.affiliation: Department of Radiology, New York University Langone Medical Center, New York, New York.
authors.forename: Alec J
authors.initials: AJ
authors.lastname: Megibow
authors.affiliation: Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Lincoln L
authors.initials: LL
authors.lastname: Berland
mesh_terms: D000066491:Clinical Decision-Making / Q000941:ethics*; D003952:Diagnostic Imaging / Q000941:ethics*; D033162:Incidental Findings; D011871:Radiology / Q000941:ethics* / Q000331:legislation & jurisprudence; D018570:Risk Assessment / Q000941:ethics / Q000331:legislation & jurisprudence; D012308:Risk Management / Q000941:ethics* / Q000331:legislation & jurisprudence*; D014342:Truth Disclosure / Q000941:ethics; D014481:United States
keywords: Incidental finding; health policy; medical decision making