Publicly Transparent Outcome Data for CT Guided ; a Patient Centered Approach

University of Virginia Department of Radiology Authors

Geoffrey Miller, MD; Arthur Pesch, MD; Christina Swanson; Genevieve Easley, MRS, RRA, RT (R); Michael Hanley, MD; Arun Krishnaraj, MD, MPH

The authors have no financial disclosures Background

• CT- guided lung are increasingly utilized to provide definite diagnosis of lung . • Reported rates range widely within the literature – 20-25% for all pneumothoraxes1 – 4-8% for pneumothoraxes requiring and subsequent admission2-4 • Patients are often unsure of their true complication risk and potential for overnight admission Benefits of Publicly Transparent Outcome Data

Reduce Patient Anxiety Facilitate Informed Decision Making

Publicly Transparent Outcome Data

Improve Patient Safety Decrease Healthcare Costs Purpose

Provide easily accessible, patient centered information regarding our center’s pneumothorax rates following CT guided lung biopsy Our Strategy for Reporting Outcome Data

Design Patient Make Data Analyze Data Friendly Publicly Infographic Available Approach

• Retrospective Review of CT Guided Lung Biopsies (November 2017-October 2018) – Pneumothoraxes on post-procedural radiograph – Pneumothoraxes requiring chest tube and subsequent admission Results Graphic

Patient Friendly Infographic Patient Friendly Infographic

Nationally Reported Ranges and Major Referral Center Rates were obtained from published data in the literature1-6 What’s Next?

• Make data publicly available – Post infographic on our UVA Radiology Website and on “Inside View”, our patient centered blog. • Post data from other procedures such as: – Thyroid FNA (Diagnostic Yield) – Liver Biopsy (Complications and Diagnostic Yield)

https://blog.radiology.virginia.edu/ Conclusion

Consumerism has increasingly prompted patients to seek health adjusted outcome data to make better informed healthcare decisions, but such data are rarely, if ever, available for radiologic procedures

In order to address this void, our department is making outcome data publicly available on our website

We hope that this effort will spark a movement in radiology where other departments will publicly report their own outcome data References

1. Boskovic T, Stanic J, Pena-karan S, et al. Pneumothorax after transthoracic needle biopsy of lung lesions under CT guidance. J Thorac Dis. 2014;6 Suppl 1:S99-S107. 2. Wagner JM, Hinshaw JL, Lubner MG, et al. CT-guided lung biopsies: pleural blood patching reduces the rate of chest tube placement for postbiopsy pneumothorax. AJR Am J Roentgenol. 2011;197(4):783-8. 3. Moreland A, Novogrodsky E, Brody L, et al. Pneumothorax with prolonged chest tube requirement after CT-guided percutaneous lung biopsy: incidence and risk factors. Eur Radiol. 2016;26(10):3483-91. 4. Heerink WJ, De bock GH, De jonge GJ, Groen HJ, Vliegenthart R, Oudkerk M. Complication rates of CT-guided transthoracic lung biopsy: meta-analysis. Eur Radiol. 2017;27(1):138-148. 5. Sachdeva M, Ronaghi R, Mills PK, Peterson MW. Complications and Yield of Computed Tomography- Guided Transthoracic Core Needle Biopsy of Lung Nodules at a High-Volume Academic Center in an Endemic Coccidioidomycosis Area. Lung. 2016;194(3):379-85. 6. Maybody M, et al. Autologous blood patch injection versus hydrogel plug in CT-guided lung biopsy: a prospective randomized trial. Radiology. 2018;290(2):547–54. Thank You!

Email: [email protected] Twitter: @geoffmillermd