Study: Patients Not Always Told When Test Results Are Abnormal

Patients are not always told when their <"">medical test results come back abnormal, according to a new study of over 5,000 patient records. Science Daily reports that the more inconsistent the notification processes, the likelier the failure to disclose.

The review looked at 5,434 patients from 23 physician offices nationwide and was led by Dr. Lawrence P. Casalino, chief of the Division of Outcomes and Effectiveness Research in the Department of Public Health of Weill Cornell Medical College, said Science Daily. Study results appear in the June 22nd Archives of Internal Medical.

The research found that doctors did not report to patients what Science Daily classified as “clinically significant abnormal test” results or failed to document that they had advised patients of such findings in one out of 14 cases in which an abnormal test result was received, or seven percent of the time, said CBC News. And, while some offices had close to no incidences of failing to report such results to patients—representing a nearly zero failure rate—others had failure rates as high as one in four patients not being told of abnormal tests, said Science Daily. CBC News explained that in these worst cases, the failure rate was as high as 26 percent.

“If you’ve had a test, whether it be blood test or some kind of X-ray or ultrasound, don’t assume because you haven’t heard from your physician that the result is normal,” said Dr. Casalino, quoted Science Daily.

The fix seems to be relatively easy explained Science Daily, citing the team. By employing and consistently utilizing “simple processes,” a physician group could experience a relatively low failure rate, said Science Daily. Likewise, when processes were not consistently used, physician groups experienced higher failure rates and also suffered from physician dissatisfaction with test result management.

The issue was not in the technology employed but, rather, in the operational processes used, according to the study, said Science Daily. For instance, electronic medical record technology could actually increase failure-to-inform rates if test result management processes were not in place. Offices using both paper and electronic records experienced the highest failure rates, said CBC News, noting that offices that suggested patients call for follow-up, experienced lower failure rates.

“If you have bad processes in place, electronic medical records are not going to solve your problems,” said study co-author Dr. Daniel Dunham of Northwestern University’s Feinberg School of Medicine in Chicago, quoted CBC News. “Failure to report abnormal test results can lead to serious, even lethal consequences for the patient,” said Dr. Casalino. “The good news is that physicians who use a simple set of systematic processes to deal with test results can greatly lessen their error rates,” quoted Science Daily.

The team offered the following five simple processes, said Science Daily:

Test results are given to the patient’s physician.

The physician signs off on his/her patients’ test results.

The practice informs patients of their test results, regardless of whether the results are positive or negative, providing that information in “general terms.”

The practice maintains a paper trail indicating that the patient has been informed.

Patients are advised to follow-up if, after receiving a test, they do not receive word on the results of that test within a specified time

“We found that very few physician practices had explicit rules for managing test results,” says Dr. Casalino. “In many practices, each physician devised his or her own method. And in many cases, physicians and their staff told patients that ‘no news is good news’—meaning they should assume that their tests are normal unless they are contacted. This is a dangerous assumption,” Dr. Casalino added, reported Science Daily.

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