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2396. Should Radiologists Discuss Imaging Results with Patients? Dissonance in Perception Between Patients and Primary Care Physicians
Authors * Denotes Presenting Author
  1. JC Panagides; Massachusetts General Hospital
  2. Nikhita Nambiar; Massachusetts General Hospital
  3. Evita Joseph; Massachusetts General Hospital
  4. Efren Flores; Massachusetts General Hospital
  5. Susan Bennett; Massachusetts General Hospital
  6. Avinash Kambadakone; Massachusetts General Hospital
  7. Dania Daye *; Massachusetts General Hospital
Objective:
Initiatives led by the Radiological Society of North American and American College of Radiology have emphasized the role of radiologists in patient-centered care [1]. We have previously piloted a point-of-care virtual radiology consult model wherein radiologists review imaging with patients and primary care providers (PCPs) in real-time during patient visits [2]. The purpose of this study is to assess the attitudes of patients and PCPs regarding the perceived value of radiologists reviewing radiologic images with patients during primary care visits.

Materials and Methods:
We conducted an IRB-approved study of video-based radiology consultations in an academic internal medicine primary care clinic between September 2019 and February 2020. The study included 44 patients, 11 participating PCPs, and 3 radiologists. Inclusion criteria included age >45, English-speaking, and having had a recent CT chest or abdomen showing atherosclerotic disease. During the PCP visit, patients reviewed their medical images with a radiologist via a third-party video interface platform. Patients and PCPs were asked to complete post-consultation surveys assessing their attitudes and experience. Surveys were internally validated. Statistical analysis was performed using Fisher’s exact test for all categorical variables.

Results:
A total of 30 patients (68.1%) and 11 participating PCPs completed the virtual radiology consult and the post-visit survey. 60% of patient respondents indicated that it had a great impact on their understanding and 40% indicated that it had some impact. However, only 33% of PCPs indicated that the radiologist discussing imaging results with patients had an impact on the patient's understanding of their medical condition and 22% indicated that it had no impact, suggesting a difference in perception with their patients (P=0.03). 8 PCPs (72%) indicated that they are often asked to explain radiologic images or results by patients and they felt comfortable doing so. 62% of PCPs predicted that results discussion between patients and radiologists would have minimal or no impact on patient cardiovascular (CV) outcomes, although the consult stimulated a discussion about CV prevention in 44% of cases.

Conclusion:
Both patients and PCPs reported an increase in patients' understanding of their medical conditions following virtual visits with a radiologist. However, this improvement was observed more frequently among patients than PCPs. This dissonance in perception warrants further investigation. While there is a perceived benefit in radiologist-patient imaging review, close collaboration with PCPs and referring providers is needed to implement such a collaborative care model.