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Physicians are concerned about “cascades of care” that follow incidental findings on diagnostic and screening tests. The prevalence and consequences of these cascades were explored in a population-based survey of 376 internists (mean age, 43) who were members of the American College of Physicians.
Essentially all respondents had witnessed cascades of care following incidental findings, and most respondents also had experienced such cascades as a patient or with a family member. Most respondents reported that these findings led to a new invasive test (77%), emergency department visit (55%), or hospitalization (51%). About 5% had been sued for missed follow-up of an incidental finding. Physicians reported various types of harms to patients, in…