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J Hosp Med. 2019 Jun 1;14(6):353-356. doi: 10.12788/jhm.3115. Epub 2019 Feb 20.

National Survey of Hospitalists' Experiences with Incidental Pulmonary Nodules.

Author information

1
University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
2
Center for Evidence-based Practice, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
3
Center for Healthcare Improvement and Patient Safety, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
4
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
5
New York Presbyterian - Columbia University Medical Center, New York, New York.
6
Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania.
7
Center for Quality Improvement, Society of Hospital Medicine, Philadelphia, Pennsylvania.
8
Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.

Abstract

Incidental pulmonary nodules (IPNs) are common and often require follow-up. The Fleischner Society guidelines were created to support IPN management. We developed a 14-item survey to examine hospitalists' exposure to and management of IPNs. The survey targeted attendees of the 2016 Society of Hospital Medicine (SHM) annual conference. We recruited 174 attendees. In total, 82% were identified as hospitalist physicians and 7% as advanced practice providers; 63% practiced for >5 years and 62% supervised trainees. All reported seeing ≥1 IPN case in the past six months, with 39% seeing three to five cases and 39% seeing six or more cases. Notwithstanding, 42% were unfamiliar with the Fleischner Society guidelines. When determining the IPN follow-up, 83% used radiology report recommendations, 64% consulted national or international guidelines, and 34% contacted radiologists; 34% agreed that determining the follow-up was challenging; only 15% reported availability of automated tracking systems. In conclusion, despite frequent IPN exposure, hospitalists are frequently unaware of the Fleischner Society guidelines and rely on radiologists' recommendations.

PMID:
30794135
DOI:
10.12788/jhm.3115

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