Providers witnessed a drop in the volume of brain MRI scans amid the pandemic while acuity leapt, a trend that could impact radiologist deployment, experts charged Thursday.
Numerous analyses have charted COVID-19’s outsized impact on the specialty, with stay-at-home orders keeping patients away from hospitals and imaging centers. Scientists at Emory University sought to explore trends in the use of magnetic resonance imaging at their own institution during the public crisis.
They discovered a roughly 17% drop in brain MRI examinations compared to pre-pandemic levels. The numbers have since rebounded, while acuity remains abnormally high, researchers detailed in Current Problems in Diagnostic Radiology.
“If this persists, this could have implications for radiologist staffing, with more complicated examinations requiring more physician time and effort,” Gelareh Sadigh, MD, a neuroradiologist, professor and health services researcher, and colleagues wrote Dec. 2.
To reach their conclusions, Emory experts used natural language processing to retrospectively categorize findings from more than 12,000 brain MRIs. They compared scans from March to August of 2019 before the pandemic up against the same six-month period in 2020. Results were classified on a three-point scale ranging from (1) “normal or near normal” to (2) “incidental or chronic findings not requiring a management change” and (3) “new or progressive findings” requiring modifications.
Sadigh et al. found that brain MRI volumes dropped almost one-fifth, from about 6,800 down to 5,600 during the pandemic’s early days. Higher acuity findings leapt “significantly,” with the most severe level increasing from 34% up to more than 40%. Volumes eventually returned to baseline during the second three months of the pandemic period, though category 3 findings still hovered near 43%. Black, older, married and underinsured patients were more likely to receive higher acuity results on brain MRI. Outpatient encounters, meanwhile, produced lower acuity results.
The authors hypothesized several reasons for the numbers, including clinical deterioration following delayed diagnoses or patients with less severe cases seeking care outside their hospital system. While the odds of higher acuity results increased for certain minority groups, the authors did not note any statistically significant racial and insurance disparity gaps.
“Future multi-institutional studies evaluating imaging acuity over longer period (as opposed to 6 months) are needed to evaluate provider- and patient-level factors that contributed to increase in imaging findings acuity during pandemic and further assess the changing health disparity gaps in imaging findings,” the authors advised.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.