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March 18, 2021

Incidentalomas and the Ethical Dilemma Behind Imaging in Clinical Research

Author Affiliations
  • 1University of Missouri–Kansas City School of Medicine, Kansas City
  • 2Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
  • 3Editor, JAMA Otolaryngology–Head & Neck Surgery
JAMA Otolaryngol Head Neck Surg. Published online March 18, 2021. doi:10.1001/jamaoto.2021.0133

In a cohort study evaluating functional brain connectivity in adults with postviral olfactory dysfunction before and after olfactory training,1 published in this issue of JAMA Otolaryngology–Head & Neck Surgery, our research group enrolled a random sample of 20 age-matched and sex-matched healthy controls to undergo functional connectivity magnetic resonance imaging (MRI) of the brain. The control participants were required to be normosmic as determined by the University of Pennsylvania Smell Identification Test. Of the 20 healthy participants, 3 (15%) had incidental findings (IFs) deemed important enough to report to the individuals for clinical follow-up. One of the individuals had a parapharyngeal mass with enlarged nearby lymph nodes and subsequently underwent otolaryngologic evaluation and surgery. The other 2 participants had cavernomas. These participants were made aware of the potential associated risks (eg, bleeding, seizures) and were advised to follow up with a neurologist or neurosurgeon. Furthermore, several of the other control participants had comments in their radiology reports, such as mild sinus disease, age-related changes, and other findings.

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