A sizable number of second-opinion radiology reports are viewed by clinicians as not worth the read, says a new study by researchers in the Netherlands.

Three radiologists at University Medical Center Groningen found that clinicians do not read a large number of second-opinion radiology reports.

“A considerable proportion of second-opinion reports are not read by clinicians, which represents an appreciable but potentially reversible waste of healthcare resources,” the authors wrote in their study.

The trio conducted a retrospective study that included 4,696 second-opinion reports of external imaging exams authorized by subspecialty radiologists at a tertiary care institution between January and December 2018. Of this number, 537 were not read by a clinician, adding up to a frequency of 11.4%.

Sonography had the highest rate of unread second-opinion reports at 62.5%, and pediatrics was the highest among request specialties (33.8%). Interventional radiology was the highest among radiologic subspecialties (52.2%).

Applying a multivariate logistic regression analysis to their findings, the authors found a number of variables remained significantly and independently associated with the second-opinion report not being read. These included inpatient status; sonography as the imaging modality; surgery or neurology as the specialty of the requesting clinician; and interventional radiology as the subspecialty of the radiologist who authorizes the second-opinion reports.

The cost of each second-opinion reading can be worth up to $118 (€100) as permitted by the National Healthcare Authority of the Netherlands. The authors assert that the 537 unread second-opinions could cost as much as $63,427 (€53,700). A second-opinion reading also takes approximately 15 minutes, meaning that approximately 134.25 hours of radiologist interpretation time would need to be devoted to reading the 537 reports.

“Although these numbers appear modest, they pertain to a single institution during a one-year time period,” the authors wrote, adding that cumulative nationwide figures would raise these totals “possibly substantially,” and that the number of unread second-opinion reports is likely to increase, “given the projected rise in future second-opinion requests.”

Opening a report in the electronic patient file system also did not necessarily mean that the clinician actually read it, indicating that the 11.4% rate of reports not read is likely an underestimation, according to the authors.

“If subspecialty radiologists and clinicians take proven determinants into account, the amount of second-opinion readings with limited additional clinical value may be reduced,” said the authors.

The findings were published in ARRS’ American Journal of Roentgenology.

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