Table 2.
Multivariable logistic regression models identifying factors associated with documentation and follow-up of incidental pulmonary nodules
| Factor | Documentation, OR (95% CI) | Follow-Up, OR (95% CI) |
|---|---|---|
| Sex | ||
| Female | Reference | Reference |
| Male | 1.16 (0.64–2.13) | 0.89 (0.47–1.68) |
| Age, by decade increment | 1.14 (0.93–1.41) | 1.16 (0.92–1.48) |
| Race and/or ethnicity | ||
| White | Reference | Reference |
| Black | 0.98 (0.49–1.94) | 1.54 (0.76–3.11) |
| Other or not reported | 0.41 (0.18–0.94) | 0.22 (0.08–0.59) |
| Preferred language | ||
| English | Reference | Reference |
| Other | 1.06 (0.42–2.66) | 1.48 (0.47–4.66) |
| Insurance | ||
| Uninsured | Reference | Reference |
| Medicaid/Medicare | 1.04 (0.48–2.26) | 0.21 (0.08–0.49) |
| Private | 0.80 (0.36–1.79) | 0.25 (0.10–0.64) |
| Smoking | ||
| Never | Reference | Reference |
| Former | 2.10 (0.87–5.06) | 1.74 (0.69–4.38) |
| Current | 1.12 (0.47–2.65) | 1.33 (0.52–3.38) |
| Not assessed | 0.71 (0.32–1.60) | 1.78 (0.70–4.55) |
| CT type | ||
| CT chest with contrast | Reference | Reference |
| CT angiogram (PE protocol) | 0.56 (0.25–1.28) | 0.38 (0.16–0.94) |
| CT chest without contrast | 0.77 (0.35–1.73) | 0.60 (0.27–1.31) |
| CT chest, abdomen, and pelvis with contrast | 0.4 (0.16–1.01) | 0.06 (0.01–0.25) |
| CT chest, abdomen, and pelvis without contrast | 0.08 (0–1.12) | 0.93 (0.06–13.2) |
| High-resolution chest CT | 0.2 (0.04–0.94) | 1.88 (0.33–10.6) |
| Other | 0.12 (0–2.25) | 0.25 (0.01–3.93) |
| Nodule size | ||
| <4.6 mm | Reference | Reference |
| 4.6–8 mm | 1.15 (0.51–2.63) | 1.79 (0.73–4.38) |
| 8–30 mm | 2.35 (0.95–5.8) | 3.04 (1.19–7.77) |
| Not reported | 1.06 (0.45–2.49) | 1.79 (0.69–4.62) |
| Nodule number | ||
| Single | Reference | Reference |
| Multiple | 1.65 (0.94–2.9) | 0.74 (0.40–1.36) |
| Radiologist’s description of nodule | ||
| Mass | Reference | Reference |
| Nodule | 0.24 (0.04–1.32) | 0.15 (0.02–0.99) |
| Ground glass | 0.2 (0.02–1.7) | 0.15 (0.01–1.67) |
| Density | 0.06 (0.01–0.47) | 0.30 (0.03–2.71) |
| Nodular density | 0.24 (0.04–1.32) | 0.09 (0.01–0.63) |
| Granuloma | 0.07 (0.01–0.65) | 0.06 (0.01–0.69) |
| Opacity | 0.09 (0.01–0.68) | 0.05 (0.01–0.43) |
| Other | 0.16 (0.02–1.06) | 0.21 (0.02–1.80) |
| Radiologist’s specialty | ||
| Not chest and body | Reference | Reference |
| Chest and body | 1.09 (0.61–1.95) | 1.76 (0.94–3.29) |
| Report location where nodule was mentioned | ||
| Findings and impression | Reference | Reference |
| Findings only | 0.30 (0.10–0.85) | 0.74 (0.24–2.27) |
| Impression only | Omitted | Omitted |
| Radiologist’s report recommended follow-up | 2.57 (1.31–5.06) | 1.03 (0.49–2.20) |
| Radiologist’s report mentioned communication of findings to ordering provider | 0.61 (0.18–2.08) | 0.52 (0.13–2.06) |
| Number of PCP visits in subsequent 2 yr | 1.11 (1.01–1.21) | 1.04 (0.96–1.12) |
| PCP-documented nodule | — | 5.85 (2.93–11.7) |
Definition of abbreviations: CI = confidence interval; CT = computed tomography; OR = odds ratio; PCP = primary care provider; PE = pulmonary embolism.