Odds of Imaging Order Higher When Clinicians Self-Interpret

TUESDAY, Sept. 8, 2026 (HealthDay News) — Providers who self-interpret imaging are significantly more likely to order outpatient imaging, according to a study published online Aug. 31 in the Journal of the American College of Radiology.

Eric W. Christensen, Ph.D., from the Harvey L. Neiman Health Policy Institute in Reston, Virginia, and colleagues examined the association between imaging ordering rates after office-based evaluation and management (E&M) visits and the percentage of a practice”s imaging studies interpreted by a radiologist versus the ordering provider. The analysis included 24.2 million E&M visits identified from the U.S. Centers for Medicare and Medicaid Services 5 percent Research Identifiable Files (2021 to 2023).

The researchers found that 13.6 percent of identified visits had imaging, and of these, 33.2 percent had ordering provider”s self-interpretation. Practices with 100 percent (versus 0 percent) radiologist interpretation had lower odds for 30-day imaging for all modalities, except computed tomography (adjusted odds ratio [aOR] ranging from 0.59 for ultrasound to 0.95 for magnetic resonance). Among ordering providers with 100 percent (versus 0 percent) self-interpretation, there were higher odds for visit-associated imaging, both overall (aOR, 2.88) and for each modality (ranging from an aOR of 1.54 for magnetic resonance to an aOR of 3.51 for ultrasound). There was variance by ordering provider subspecialty and patient diagnosis.

“Policy that establishes more stringent standards for nonradiologist interpretation may reduce inappropriate imaging that increases economic burdens and poses patient-safety risks,” Christensen said in a statement. “In fact, our analyses indicate that office-based imaging could potentially be reduced by 17 percent in the absence of self-interpretation.”

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