Journal
NEUROLOGY
Volume 77, Issue 24, Pages 2123-2127Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e31823d7687
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Funding
- NIH
- NCCR
- Department of Energy
- Defense Advanced Research Projects Agency
- Delle Foundation
- John Templeton Foundation
- University of New Mexico
- CTSC
- National Multiple Sclerosis Society
- Office of Naval Research
- Sandia University
- Suzie Poole Foundation
- UNM SOM
- NIH (NIMH)
- NIH (NIBIB)
- NIH (NCRR)
- National Science Foundation
- NIH (NIAAA)
- NIH (NIDA)
- Swiss NSF [CTSC001-1, 1-KL2-RR31976-1, 1-UL1-RR031977, 1-R01-AG029495-03, 1-R21-MH080141-02, 1-R01-AG020302-05, R01-AA017390, 5-P20-RR021938, 1-R03-DA027892-01, R01-MH072681, R01-MH070539, 1-R01-MH085010-01A1, R01-MH071896]
- Swiss-NSF [5-M01-RR000997-35, 1-R01-HD059856-01A2, 1-R01-EB002618-01, 1-R21-DA027149-A1, 1-R21-DA029464, 1-R41-NS062474-01, DE-FG02-99ER62764, 1-R01-DA14178-01, R01-HL04722-A5, 3-R01-NS052305, 1-R21-DA027149-01, P20-AA017068, 5-R01-AA012238, 5-R01-AA014886, 1-R01-DA025074]
- Swiss (NSF) [R01-DA020870, 1-R01-DA026505-01A1, 5-P20-AA017068, DE-FG02-08ER64581, 1-R03-DA022435-01A1, R24-HD050836, R21-NS064464-01A1, 5-R21-HD041237-02, 5-M01-RR00997, 5-U24-AA014811-06, 1-R21-DA025135, PA001-113097, NBCHC070103, NBCHC090055]
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Objective: We describe the systematic approach to incidental findings (IFs) used at the Mind Research Network (MRN) where all MRI scans receive neuroradiologist interpretation and participants are provided results. Methods: From 2004 to 2011, 8,545 MRI scans were acquired by 45 researchers. As mandated by MRN's external institutional review board, all structural sequences were evaluated by a clinical neuroradiologist who generated a report that included recommendations for referral if indicated. Investigators received a copy of their participants' reports, which were also mailed to participants unless they specifically declined. To better understand the impact of the radiology review process, a financial analysis was completed in addition to a follow-up phone survey to characterize participant perceptions regarding receiving their MRI scan results. Results: The radiologist identified IFs in 34% of the 4,447 participants. Of those with IFs (n = 1,518), the radiologist recommended urgent or immediate referral for 2.5% and routine referral for 17%. For 80.5%, no referral was recommended. Estimated annual cost for this approach including support for the neuroradiologist, medical director, and ancillary staff is approximately $60,000 or $24/scan. The results of the retrospective phone survey showed that 92% of participants appreciated receiving their MRI report, and the majority stated it increased their likelihood of volunteering for future studies. Conclusions: Addressing IFs in a cost-effective and consistent manner is possible by adopting a policy that provides neuroradiology interpretation and offers participant assistance with clinical follow-up when necessary. Our experience suggests that an ethical, institution-wide approach to IFs can be implemented with minimal investigator burden. Neurology (R) 2011; 77: 2123-2127
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