Table 1.
Comparison of nodule documentation and follow-up among study patients
| Characteristics | Documentation of Nodule |
Follow-Up of Nodule |
|||||
|---|---|---|---|---|---|---|---|
| All Patients (n = 344) | Documentation (n = 181) | No Documentation (n = 163) | P Value* | Follow-Up (n = 140) | No Follow-Up (n = 204) | P Value† | |
| Sex | |||||||
| Female | 182 (53) | 101 (56) | 81 (50) | 0.26 | 79 (56) | 103 (50) | 0.28 |
| Male | 162 (47) | 80 (44) | 82 (50) | 61 (44) | 101 (50) | ||
| Age, yr, mean ± SD | 53.5 ± 16.4 | 58.0 ± 14.7 | 48.4 ± 16.7 | <0.001 | 57.8 ± 12.9 | 50.5 ± 17.8 | <0.001 |
| Race and/or ethnicity | |||||||
| White, not Hispanic | 135 (39) | 80 (44) | 55 (34) | <0.001 | 63 (45) | 72 (35) | <0.001 |
| Black, not Hispanic | 97 (28) | 61 (34) | 36 (22) | 53 (38) | 44 (22) | ||
| Other or not reported | 112 (33) | 40 (22) | 72 (44) | 24 (17) | 88 (43) | ||
| Preferred language | |||||||
| English | 277 (81) | 158 (87) | 119 (73) | 0.001 | 125 (89) | 152 (75) | 0.001 |
| Other | 67 (19) | 23 (13) | 44 (27) | 15 (11) | 52 (25) | ||
| Insurance | |||||||
| Uninsured | 72 (21) | 38 (21) | 34 (21) | 0.04 | 38 (27) | 34 (17) | 0.03 |
| Medicaid/Medicare | 167 (49) | 98 (54) | 69 (42) | 67 (48) | 100 (49) | ||
| Private | 105 (30) | 45 (25) | 60 (37) | 35 (25) | 70 (34) | ||
| Smoking | |||||||
| Never | 66 (19) | 33 (18) | 33 (20) | <0.001 | 22 (16) | 44 (21) | 0.005 |
| Former | 81 (24) | 57 (32) | 24 (15) | 45 (32) | 36 (18) | ||
| Current | 76 (22) | 45 (25) | 31 (19) | 34 (24) | 42 (21) | ||
| Not assessed | 121 (35) | 46 (25) | 75 (46) | 39 (28) | 82 (40) | ||
| CT type | |||||||
| CT of chest with contrast | 128 (37) | 83 (46) | 45 (28) | <0.001 | 70 (50) | 58 (28) | <0.001 |
| CT angiogram (PE protocol) | 76 (22) | 32 (17) | 44 (27) | 21 (15) | 55 (27) | ||
| CT of chest without contrast | 71 (20) | 45 (25) | 26 (16) | 36 (26) | 35 (17) | ||
| CT of chest, abdomen, and pelvis with contrast | 47 (14) | 14 (8) | 33 (20) | 3 (2) | 44 (22) | ||
| CT of chest, abdomen, and pelvis without contrast | 6 (2) | 1 (0.5) | 5 (3) | 2 (1) | 4 (2) | ||
| High-resolution chest CT | 10 (3) | 5 (3) | 5 (3) | 7 (5) | 3 (1.5) | ||
| Other | 6 (2) | 1 (0.5) | 5 (3) | 1 (1) | 5 (2.5) | ||
| Nodule size was reported | 222 (65) | 136 (75) | 86 (53) | <0.001 | 102 (73) | 120 (59) | 0.008 |
| Nodule size, mm, median (IQR) | 6.0 (4.0–9.9) | 7.0 (4.2–11) | 5.0 (3–8) | <0.001 | 7.65 (5–12) | 5 (3–8) | <0.001 |
| Nodule number | |||||||
| Single | 168 (49) | 79 (44) | 89 (55) | 0.04 | 68 (49) | 100 (49) | 0.9 |
| Multiple | 176 (51) | 102 (56) | 74 (45) | 72 (51) | 104 (51) | ||
| Radiologist’s description of nodule | |||||||
| Mass | 14 (4) | 11 (6) | 3 (2) | 0.002 | 11 (8) | 3 (2) | 0.002 |
| Nodule | 180 (52) | 106 (59) | 74 (46) | 0.002 | 81 (58) | 99 (48) | |
| Ground glass | 15 (4) | 8 (4) | 7 (4) | 6 (4) | 9 (4) | ||
| Density | 18 (5) | 6 (3) | 12 (7) | 9 (6) | 9 (4) | ||
| Nodular density | 49 (14) | 26 (14) | 23 (14) | 17 (12) | 32 (16) | ||
| Granuloma | 20 (6) | 3 (2) | 17 (11) | 3 (2) | 17 (8) | ||
| Opacity | 24 (7) | 9 (5) | 15 (9) | 4 (3) | 20 (10) | ||
| Other | 24 (7) | 12 (7) | 12 (7) | 9 (6) | 15 (7) | ||
| Radiologist’s specialty | |||||||
| Not chest and body | 151 (44) | 79 (44) | 72 (44) | 0.92 | 57 (41) | 94 (46) | 0.32 |
| Chest and body | 193 (56) | 102 (56) | 91 (56) | 83 (59) | 110 (54) | ||
| Report location where nodule was mentioned | |||||||
| Findings and impression | 291 (85) | 174 (96) | 117 (72) | <0.001 | 132 (94) | 159 (78) | < 0.001 |
| Findings only | 50 (14) | 7 (4) | 43 (26) | 8 (6) | 42 (21) | ||
| Impression only | 3 (1) | 0 | 3 (2) | 0 | 3 (1) | ||
| Radiologist’s report recommended follow-up | 197 (57) | 132 (73) | 65 (40) | <0.001 | 97 (69) | 100 (49) | <0.001 |
| Fleischner statement included | 27 (8) | 16 (9) | 11 (7) | 0.47 | 9 (6) | 18 (9) | 0.42 |
| Radiologist’s report mentioned communication of findings to ordering provider | 20 (6) | 10 (6) | 10 (6) | 0.81 | 8 (6) | 12 (6) | 0.95 |
| Number of PCP visits in subsequent 2 yr, mean ± SD | 1.91 ± 3.68 | 2.75 ± 4.34 | 0.98 ± 2.47 | <0.001 | 2.73 ± 3.99 | 1.35 ± 3.35 | <0.001 |
| Death | 34 (10) | 24 (13) | 10 (6) | 0.03 | 15 (11) | 19 (9.5) | 0.71 |
Definition of abbreviations: CT = computed tomography; IQR = interquartile range; PCP = primary care provider; PE = pulmonary embolism.
Data are presented as number (percent) unless otherwise specified.
*
P value represents comparison of characteristics between group with documentation and group with no documentation.
†
P value represents comparison of characteristics between group with follow-up and group with no follow-up.