Talk:Incidental imaging finding

The main point of this article unstated?

I'm not a doctor, but I would have thought that the most important aspect of this subject is the issue of the unnecessary distress of many patients after being told by doctors that they may have cancer. In my experience, some patients in this situation do not appear to understand that the odds are that they don't have cancer, and one can ask whether doctors are explaining the facts to patients properly.

Book chapter on this subject worth citing?

This newish book for a general readership is highly regarded: http://www.amazon.com/Overdiagnosed-Making-People-Pursuit-Health/dp/0807022004 I'm not the author, or in any way connected to this book.

No dilemma here

I removed this statement: " the clinician is often faced with the dilemma whether to inform the patient of this finding, particularly if it is not completely certain if the finding is harmless." -- Not so. The clinician has always the duty to inform the patient. The issue may be how far to go to prove that the lesion is harmless. Ekem 19:09, 15 February 2006 (UTC)

Removed

This reference was in the article:

Hayward R. VOMIT (victims of modern imaging technology)—an acronym for our times. BMJ 2003;326:1273

Very funny, but there is no material in the article that refers to it. Until such is written, I've moved it here. JFW | T@lk 15:25, 10 June 2007 (UTC)

Article should be deleted

This is not a diagnostic term, nor is it a clinical term. Anyone who thinks the term is useful or important ought to post the citation they believe confers credibility to the term. It may be tough to find peer-reviewed citations for medical articles but those that aren't should at least include a way top find the etymology. Just appearing on a website does not confer credibility.

Online notes from a note service run at any WHO-approved medical school would be great, in my view. Kernel.package (talk) 01:36, 11 April 2011 (UTC)

No, Wikipedia doesn't need to be linked with educational material from medical schools. Quite on the contrary, those would not be regarded as WP:MEDRS.

If you had bothered looking at the references, you would have noted that incidentally found tumours on medical imaging are an exceedingly common problem, and a conundrum for the treating physician. The concept deserves its own article, no question. It is verifiable, notable and neutral. JFW | T@lk 08:04, 11 April 2011 (UTC)

Proposed merger with Incidental findings

This article, besides promoting a dubious medical colloquialism, duplicates much of what is discussed in the article, Incidental findings. Neither of these articles, however, have a particularly compelling title. Thoughts? Dr G (talk) 11:23, 24 July 2017 (UTC)

Nootherone321 Both topics meet WP:N, so I think that they could have their own Wikipedia articles. As you say, the topics overlap, and I agree that by merging we could have one better article instead of two lesser quality ones. I also agree that the names are a distraction, and that behind the name, this overarching concept appears in publication without using these particular names and by other names.

If someone were to find a good research paper which was obviously describing this concept but not using this name, then that would be supporting evidence that this concept goes by other names. I would want to see a case made that the literature uses other names before I support a rename. This name is dubious, but it is also popular and used. I do not know what other names are in popular use but I suspect there must be alternatives which seem less like a joke. I could be wrong, and maybe this is the name. Blue Rasberry (talk) 15:34, 24 July 2017 (UTC)

The more I dig into this, the more interesting it gets. "Incidentaloma" seems to have originated with the advent of CT scans, and the term appears to have been initially used specifically to refer to incidentally-discovered adrenal nodules. After this was popularized, it seems to have been generalized to refer to any incidentally discovered tumor. Searching through current medical literature, the colloquial term is still regularly used in this way.

Regardless, I do believe the two pages should be combined. As it stands, the Incidental findings article - although broadly defined in the introductory paragraph ("previously undiagnosed medical or psychiatric conditions")— essentially only discusses imaging-detected tumors... incidentalomas. I think it makes the most sense to have a general article on incidental medical findings, with "incidentaloma" being a sub-section.

References

Dr G (talk) 16:37, 24 July 2017 (UTC)

Nootherone321 How do you think we should go forward? I checked incoming links. About 50 articles link to this one. I checked some out, and I think about half are in the context of the economics and safety of unnecessary health care and the rest are in the context of medical practice. I think that we might execute the merge if we confirm our agreement. For me to confirm I think that I would want to see ~2 sources which define "incidental findings" to confirm that as an appropriate name. Alternatively, we could call for other opinions by making a request at Wikipedia:Requested moves/Controversial. I am not sure what is best at this point. Blue Rasberry (talk) 12:25, 25 July 2017 (UTC)

Bluerasberry I think that merging the two as you described sounds reasonable. Searching the literature, and focusing on the theme of ethical implications of unexpected diagnoses, multiple sources use the term "incidental findings." For example, recent review papers from the genetics and radiology literature use this phrase. Reassuringly, a review article in the journal of the Canadian Medical Associationprovides the following definition (which may be useful for the article):

Incidental findings are becoming increasingly common as advanced medical technologies are used in research and clinical care. These potentially relevant findings fall outside the primary purpose for conducting a test or procedure. Incidental findings may be anticipated (known to be potentially associated with the test) or unanticipated (not typically associated). Secondary findings are actively sought but not the primary reason for testing.

References

Dr G (talk) 19:48, 26 July 2017 (UTC)

January 2018 merger discussion

From "incidental findings" -

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I propose that the new merged page be titled "incidental medical finding," or perhaps more specifically "incidental imaging finding." The term "incidentaloma" is a medical colloquialism. Although it is commonly used, there is no concrete etymology and terminology of "incidental findings" has been adopted by several medical societies, as discussed on the talk page for incidentaloma.

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@Nootherone321: I can support changing "incidental findings" to "incidental medical findings". I also agree that the names "incidentaloma" and "incidental findings" seems like jokes, but also, these terms are established in academic literature now so regardless of their origins they are the names that experts and expert societies use. I am not aware of competing popular terms for these concepts. I do not agree that these terms are colloquialisms at this point because they are cemented in professional practice, despite the casual etymological origins.

I agree that most of the publication on "incidental medical findings" is about tumors founding in medical imaging, termed "incidentalomas". I will neither quickly object nor quickly agree to a merger of incidentaloma and incidental medical findings. Although incidentaloma is the most discussed example of incidental findings, both concepts have established notability and there is a lot of content on both. If the concepts are merged, then I also would not object to anyone splitting the concepts again especially if anyone felt like adding a few sentences or another paragraph to the findings information which is not about tumors.

Can you say more about why you think merging is best? If the general findings article were expanded, would you not want it separated? Blue Rasberry (talk) 17:29, 4 January 2018 (UTC)

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@Bluerasberry: I totally agree on the breadth of general topic of incidental findings, meaning any sort of unexpected medical diagnoses descried during an unrelated evaluation. Whether consisting of a mass discovered by CT scan or a genetic defect revealed by direct-to-consumer DNA testing, these all result in the same ethical, legal, and practical dilemma: what is best done with the information? Based on these commonalities, I believe all may be accurately subsumed under an article entitled "Incidental medical findings."

My proposal for merging was based on the current state of the pages, in which both articles are sub-optimal. The incidental findings article mostly deals with radiology findings, yet ignores all incidental non-tumor imaging findings. Ideally, a complete article would go far beyond radiology, and include genetic, autopsy, and psychiatric sub-sections.

The incidentaloma article is problematic in both title and style. While the term "incidentaloma" is used synonymously with "incidental findings" in some academic publications, it is decidedly an alternative term (for example Managing Incidental Findings on Abdominal CT). Indeed, all American College of Radiology white papers on the subject are entitled "incidental findings" and not "incidentaloma" (see listing here). In terms of article content, it is beginning to resemble a cook-book for medical management of incidental imaging findings, going against the manual of style for medicine by addressing a professional audience. My thought was that by merging this page under the more general topic of "incidental medical findings," the thrust of the article would be re-directed away from step-by-step diagnostic evaluations.

If the incidental findings article is expanded, perhaps merging is not the way to go. Still, would continue to argue that "incidentaloma" is not the best article title, but certainly a good redirect? Continue to agree with renaming incidental findings → incidental medical findings. Dr G (talk) 06:33, 6 January 2018 (UTC)

I do not object to a rename of "incidentaloma" but do think that the name is common enought to justify that being not less than a secondary name stated in the first sentence. I also am in agreement with the poor shape of both articles. I do not have capacity right now to clean this, and even I do not object to a merge if that is a path to cleaning it for now. Even if merging does solve problems now, I still feel that in the longer term there will likely be a general article for incidental findings then forked articles for findings in oncology, genetics, and whatever else. We are not lacking in source content to establish notability for subtopics. Blue Rasberry (talk) 16:27, 6 January 2018 (UTC)

@Bluerasberry: Absolutely agree. I will move forward with renaming and including "incidentaloma" in the first sentence. I am choosing "incidental imaging finding" over "incidental radiology finding" on the basis of vastly greater number of google search matches (16 million vs 522 thousand).Dr G (talk) 21:48, 18 January 2018 (UTC)