National Survey of Hospitalists' Experiences with Incidental Pulmonary Nodules

J Hosp Med. 2019 Jun 1;14(6):353-356. doi: 10.12788/jhm.3115. Epub 2019 Feb 20.


Incidental pulmonary nodules (IPNs) are common and often require follow-up. The Fleischner Society guidelines were created to support IPN management. We developed a 14-item survey to examine hospitalists' exposure to and management of IPNs. The survey targeted attendees of the 2016 Society of Hospital Medicine (SHM) annual conference. We recruited 174 attendees. In total, 82% were identified as hospitalist physicians and 7% as advanced practice providers; 63% practiced for >5 years and 62% supervised trainees. All reported seeing ≥1 IPN case in the past six months, with 39% seeing three to five cases and 39% seeing six or more cases. Notwithstanding, 42% were unfamiliar with the Fleischner Society guidelines. When determining the IPN follow-up, 83% used radiology report recommendations, 64% consulted national or international guidelines, and 34% contacted radiologists; 34% agreed that determining the follow-up was challenging; only 15% reported availability of automated tracking systems. In conclusion, despite frequent IPN exposure, hospitalists are frequently unaware of the Fleischner Society guidelines and rely on radiologists' recommendations.

MeSH terms

  • Aftercare / standards
  • Guideline Adherence / standards
  • Guideline Adherence / statistics & numerical data*
  • Hospitalists / statistics & numerical data*
  • Humans
  • Incidental Findings*
  • Lung Neoplasms / diagnostic imaging*
  • Solitary Pulmonary Nodule / diagnostic imaging*
  • Surveys and Questionnaires
  • Tomography, X-Ray Computed / standards*