U.S. doctors fail to report abnormal test results to patients seven per cent of the time, a new study suggests.

"If you've had a test, whether it be blood test or some kind of X-ray or ultrasound, don't assume because you haven't heard from your physician that the result is normal," said the study's lead author, Dr. Lawrence Casalino of Weill Cornell Medical College in New York.

In this week's Archives of Internal Medicine, Casalino and his colleagues analyzed more than 5,000 randomly selected records of patients aged 50 to 69 from 23 physician practices in the U.S. Midwest and West Coast.

A clinically significant abnormal result was found in one of 11 blood or screening tests for conditions such as high cholesterol, diabetes, colon cancer, breast cancer and cervical cancer.

Doctors failed to inform patients 7.1 per cent of the time, or about one of every 14 tests. Performances varied widely among practices, from zero per cent to 26 per cent failure rates.

In 135 cases of 1,889 abnormal test results, the patient was either not informed of the finding or the office had not documented that the result was communicated to the patient.

Electronic medical records little help

Practices that used a combination of paper and electronic medical records had the highest failure rates.

"If you have bad processes in place, electronic medical records are not going to solve your problems," said study co-author Dr. Daniel Dunham of Northwestern University's Feinberg School of Medicine in Chicago.

On the other hand, offices that asked patients to call if they didn't hear any news were less likely to have high failure rates.

The study's authors suggested five steps for practices to take in dealing with test results:

  1. Send all test results to the responsible physician.
  2. Have the physician sign off on all results.
  3. Practices should inform patients of all results, normal and abnormal, at least in general terms.
  4. Practices should document that the patient has been informed.
  5. Tell patients to call after a certain time interval if they have not been notified of the result.

The researchers excluded dying patients and cases with severe medical conditions where informing a patient would be redundant.

The study was funded by the California HealthCare Foundation.