The PROgnostic Value of unrequested Information in Diagnostic Imaging PROVIDI Study: rationale and designReportar como inadecuado

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European Journal of Epidemiology

, Volume 25, Issue 10, pp 751–758

First Online: 02 October 2010Received: 13 April 2010Accepted: 15 September 2010


We describe the rationale for a new study examining the prognostic value of unrequested findings in diagnostic imaging. The deployment of more advanced imaging modalities in routine care means that such findings are being detected with increasing frequency. However, as the prognostic significance of many types of unrequested findings is unknown, the optimal response to such findings remains uncertain and in many cases an overly defensive approach is adopted, to the detriment of patient-care. Additionally, novel and promising image findings that are newly available on many routine scans cannot be used to improve patient care until their prognostic value is properly determined. The PROVIDI study seeks to address these issues using an innovative multi-center case-cohort study design. PROVIDI is to consist of a series of studies investigating specific, selected disease entities and clusters. Computed Tomography images from the participating hospitals are reviewed for unrequested findings. Subsequently, this data is pooled with outcome data from a central population registry. Study populations consist of patients with endpoints relevant to the group of diseases under study along with a random control sample from the cohort. This innovative design allows PROVIDI to evaluate selected unrequested image findings for their true prognostic value in a series of manageable studies. By incorporating unrequested image findings and outcomes data relevant to patients, truly meaningful conclusions about the prognostic value of unrequested and emerging image findings can be reached and used to improve patient-care.

KeywordsCase-cohort Computed tomography Epidemiology Outcome analysis Research design AbbreviationsAntonius St. Antonius hospital Nieuwegein

AMCAcademic medical center Amsterdam

AZMAcademic hospital Maastricht

CTComputed tomography

ElkerliekElkerliek hospital Helmond

GelreGelre hospital Apeldoorn

ICDInternational classification of disease

kVpkiloVoltage peak

MaSMilliampere seconds

MDCTMulti detector row computed tomography

MRIMagnetic resonance Imaging

PROVIDIPROgnostic Value of unrequested Information in Diagnostic Imaging

UMCGUniversity medical center Groningen

UMCUUniversity medical center Utrecht

VUMCVU University medical center Amsterdam

On behalf of the PROVIDI study group.

Please refer the -Appendix- section for PROVIDI study group members.

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Autor: M. J. A. Gondrie - W. P. Th. M. Mali - C. F. M. Buckens - P. C. A. Jacobs - D. E. Grobbee - Y van der Graaf


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