Featured Research

from universities, journals, and other organizations

Medical imaging may detect unrelated diseases in research participants

Date:
September 28, 2010
Source:
JAMA and Archives Journals
Summary:
In about 40 percent of research participants undergoing medical imaging, radiologists may detect a tumor or infection unrelated to the study but that may be meaningful to the individual's health, according to a new study.

In about 40 percent of research participants undergoing medical imaging, radiologists may detect a tumor or infection unrelated to the study but that may be meaningful to the individual's health, according to a report in the September 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

"An incidental finding in human subjects research is defined in a major consensus project as an observation 'concerning an individual research participant that has potential clinical importance and is discovered in the course of conducting research, but is beyond the aims of the study,'" the authors write as background information in the article. "Numerous reports have detailed how the detection of an incidental finding can result in the early beneficial diagnosis of an unsuspected malignant neoplasm or aneurysm. However, others describe harm and excessive cost resulting from treatment of radiographically suspicious incidental findings. Moreover, clinical experience dictates that many incidental findings are of indeterminate clinical significance and generate uncertainty among both research participants and their physicians."

Nicholas M. Orme, M.D., of Mayo Clinic, Rochester, Minn., and colleagues evaluated the medical records of 1,426 research participants who underwent an imaging procedure related to a study conducted in 2004. Each image was interpreted by a radiologist the day it was performed, and an expert panel reviewed all incidental findings that resulted in a clinical action during a three-year follow-up period.

Of the 1,426 research imaging examinations, an incidental finding occurred in 567 (39.8 percent). The risk of an incidental finding increased with age. More incidental findings were generated in patients undergoing computed tomography (CT) scans of the abdomen and pelvic area than in any other imaging procedure, followed by CT of the chest and magnetic resonance imaging (MRI) of the head.

Clinical action was taken for 35 (6.2 percent) of the individuals with an incidental finding; in most cases (26 of 567, or 4.6 percent) the medical benefit or burden of these actions was unclear. However, action resulted in clear medical benefit for six of the 567 patients (1.1 percent) and clear medical burden in three patients (0.5 percent).

"This study demonstrates that research imaging incidental findings are common in certain types of imaging examinations, potentially offering an early opportunity to diagnose asymptomatic life-threatening disease, as well as a potential invitation to invasive, costly and ultimately unnecessary interventions for benign processes," the authors write. "The majority of incidental findings seem to be of unclear significance. These instances represent a dilemma for researchers."

The findings should help researchers identify imaging studies at high risk for generating incidental findings and develop a plan for managing them, the authors conclude. "Timely, routine evaluation of research images by radiologists can result in identification of incidental findings in a substantial number of cases that can result in significant medical benefit to a small number of patients," they write.

Editorial: Researchers Must Plan for Incidental Findings

"In clinical research, investigators may learn information about a participant that is not pertinent to the research question but that may have important clinical implications for the participant," writes Bernard Lo, M.D., of the University of California, San Francisco, in an accompanying editorial. "Such incidental findings present ethical dilemmas. Although they may offer the possibility of substantial personal benefit to the participant, more commonly they are false-positive findings that lead to a cascade of testing that presents additional risks and burdens."

"When planning a study, researchers need to develop a comprehensive plan for how they will respond to incidental findings, including what findings they will offer to disclose to participants," Dr. Lo continues. "The possibility of incidental findings, and their ramifications, should be part of the informed consent process. The work by Orme et al helps us to start to quantify their impact."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal References:

  1. N. M. Orme, J. G. Fletcher, H. A. Siddiki, W. S. Harmsen, M. M. O'Byrne, J. D. Port, W. J. Tremaine, H. C. Pitot, E. G. McFarland, M. E. Robinson, B. A. Koenig, B. F. King, S. M. Wolf. Incidental Findings in Imaging Research: Evaluating Incidence, Benefit, and Burden. Archives of Internal Medicine, 2010; 170 (17): 1525 DOI: 10.1001/archinternmed.2010.317
  2. B. Lo. Responding to Incidental Findings on Research Imaging Studies: Now What? Archives of Internal Medicine, 2010; 170 (17): 1522 DOI: 10.1001/archinternmed.2010.306

Cite This Page:

JAMA and Archives Journals. "Medical imaging may detect unrelated diseases in research participants." ScienceDaily. ScienceDaily, 28 September 2010. <www.sciencedaily.com/releases/2010/09/100927162247.htm>.
JAMA and Archives Journals. (2010, September 28). Medical imaging may detect unrelated diseases in research participants. ScienceDaily. Retrieved July 22, 2014 from www.sciencedaily.com/releases/2010/09/100927162247.htm
JAMA and Archives Journals. "Medical imaging may detect unrelated diseases in research participants." ScienceDaily. www.sciencedaily.com/releases/2010/09/100927162247.htm (accessed July 22, 2014).

Share This




More Health & Medicine News

Tuesday, July 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

TheStreet (July 21, 2014) New research shows Gilead Science's drug Sovaldi helps in curing hepatitis C in those who suffer from HIV. In a medical study, the combination of Gilead's Hep C drug with anti-viral drug Ribavirin cured 76% of HIV-positive patients suffering from the most common hepatitis C strain. Hepatitis C and related complications have been a top cause of death in HIV-positive patients. Typical medication used to treat the disease, including interferon proteins, tended to react badly with HIV drugs. However, Sovaldi's %1,000-a-pill price tag could limit the number of patients able to access the treatment. TheStreet's Keris Lahiff reports from New York. Video provided by TheStreet
Powered by NewsLook.com
$23.6 Billion Awarded To Widow In Smoking Lawsuit

$23.6 Billion Awarded To Widow In Smoking Lawsuit

Newsy (July 20, 2014) Cynthia Robinson claims R.J. Reynolds Tobacco Company hid the health and addiction risks of its products, leading to the death of her husband in 1996. Video provided by Newsy
Powered by NewsLook.com
Tooth Plaque Provides Insight Into Diets Of Ancient People

Tooth Plaque Provides Insight Into Diets Of Ancient People

Newsy (July 19, 2014) Research on plaque from ancient teeth shows that our prehistoric ancestor's had a detailed understanding of plants long before developing agriculture. Video provided by Newsy
Powered by NewsLook.com
Contaminated Water Kills 3 Babies in South African Town

Contaminated Water Kills 3 Babies in South African Town

AFP (July 18, 2014) Contaminated water in South Africa's northwestern town of Bloemhof kills three babies and hospitalises over 500 people. The incident highlights growing fears over water safety in South Africa. Duration: 02:22 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins