Design: Retrospective single-centre review
Population: 243 reports with follow-up recommendations for 164 incarcerated patients
Primary outcome: Outpatient completion within the recommended interval
Effect: 8.6% (12/140) completed on time; any follow-up 33.3%

A retrospective review in the Journal of the American College of Radiology (7 October) identified 243 radiology reports with a definite follow-up recommendation for 164 incarcerated patients seen in the emergency department or as inpatients at one US centre between 2017 and 2024.

Of 140 recommendations with a clear interval, only 12 (8.6%) were completed as outpatients within the recommended window. Any follow-up was documented in a third of reports, about equally split between planned outpatient studies, studies done incidentally on later admissions, and studies completed during the original stay.

A recommendation in a report is not a plan unless someone owns it. For patients whose care passes between institutions, including prisoners, migrants and those discharged far from home, this shows how often recommendations are lost. Closed-loop tracking, or completing the study during the index admission where reasonable, are the levers radiology controls.

Flag actionable follow-up recommendations through a tracking or closed-loop system rather than relying on the report alone.
Consider completing recommended imaging before discharge when the patient may not return.
State the follow-up interval and modality explicitly so it can be tracked.
Communicate recommendations directly to the team responsible after discharge, including correctional health services.

Why it matters

An incidental finding in a patient who cannot easily return is a recommendation likely never acted on.

The statistics, in plain English

This is a single-centre count, and follow-up done at other institutions would not have been captured, so the true completion rate may be somewhat higher.