Communication of incidental findings in the ED: Patient perspectives.

The study was done in one urban academic emergency department, so preferences may not transfer to community, rural, or differently resourced settings. Only 16 patients completed interviews, and the sample was purposive, not designed to represent all ED patients or all incidental findings. Participants were English-speaking adults undergoing abdominal imaging; non-English speakers, patients with cognitive impairment, dementia, acute psychiatric illness, or clinical instability were excluded. Patients did not necessarily have an incidental finding, because interviews were conducted during ED workflow and not timed to results. The interviews were originally collected for an implementation study, and this secondary analysis was not designed for data saturation; no new codes emerged after nine transcripts. Most participants were insured, had mid-range income, had higher educational attainment, and were in good health, so generalizability may be limited. Interviews occurred in active ED treatment areas, so noise, interruptions, or discomfort may have affected responses. The study describes preferences and experiences, not whether any communication approach improves understanding, distress, follow-up, or outcomes. The authors state that the findings should not be interpreted as prescriptive recommendations for all patients.

Do not read these themes as evidence that a communication protocol improves patient outcomes. The study interviewed 16 patients who did not necessarily have incidental findings and tested no intervention.