51
|
Communication errors in radiology – Pitfalls and how to avoid them. Clin Imaging 2018; 51:266-272. [DOI: 10.1016/j.clinimag.2018.05.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 05/11/2018] [Accepted: 05/31/2018] [Indexed: 12/21/2022]
|
52
|
Structured reporting in petrous bone MRI examinations: impact on report completeness and quality. Int J Comput Assist Radiol Surg 2018; 13:1971-1980. [DOI: 10.1007/s11548-018-1828-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/16/2018] [Indexed: 12/16/2022]
|
53
|
How confident are general practitioners in interpreting neuroradiology reports? Clin Radiol 2018; 73:944-950. [PMID: 30025590 DOI: 10.1016/j.crad.2018.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 06/20/2018] [Indexed: 11/23/2022]
Abstract
AIM To determine the level of confidence general practitioners (GPs) have in radiology reports provided by neuroradiologists and to elicit the preferences of GPs regarding report format and level of detail. MATERIALS AND METHODS Electronic surveys comprising anonymised neuroradiology reports were sent to GP practices served by a tertiary neuroscience centre. After reviewing the reports, GPs were asked to complete a two-part questionnaire. Firstly, GPs indicated their level of confidence, using a five-tiered Likert scale, in their understanding of: (a) the body of text; (b) the meaning of the report; and (c) the significance of the report. Secondly, GPs provided free-text suggestions for improving the report and highlighted any phrases that they did not understand. RESULTS One hundred GPs responded from a group of 439 that received a survey (response rate 23%). Although the majority of GPs were fairly confident in their understanding of reports, fewer than one-third of GPs were entirely confident. Approximately 10% of GPs were not confident at all in their understanding of the reports. Causes of confusion included the use of detailed anatomy, acronyms, radiological terminology, and a lack of a conclusion and an action plan. CONCLUSION General practice is a time-sensitive discipline that demands clear communication. In neuroradiology reports, GPs do not find detailed anatomy, acronyms, or radiological terminology helpful. Rather, GPs want a clear conclusion and action plan.
Collapse
|
54
|
Pool FJ, Siemienowicz ML. New RANZCR clinical radiology written report guidelines. J Med Imaging Radiat Oncol 2018; 63:7-14. [PMID: 30019848 DOI: 10.1111/1754-9485.12756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 05/21/2018] [Indexed: 12/17/2022]
Abstract
The Royal Australian and New Zealand College of Radiologists (RANZCR) Radiology Written Report Guideline was first issued in 2011. A survey-based consultation of clinical radiology members of the college in 2015 found that the vast majority of 235 respondents supported all components of the guideline. Since the original guideline was developed, considerable new research has been published about radiology reporting, particularly regarding structured/template reports. In 2016/17 a RANZCR working group used the consultation results, stakeholder feedback and recent research to develop revised guidelines. This article outlines the consultation survey results and guideline revision process as well as some of the supporting evidence from the literature.
Collapse
Affiliation(s)
- Felicity Jane Pool
- Department of Diagnostic Imaging, National University Hospital, Singapore
| | | |
Collapse
|
55
|
Structured reporting of x-rays for atraumatic shoulder pain: advantages over free text? BMC Med Imaging 2018; 18:20. [PMID: 29970014 PMCID: PMC6029150 DOI: 10.1186/s12880-018-0262-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 06/12/2018] [Indexed: 11/17/2022] Open
Abstract
Background To analyse structured and free text reports of shoulder X-ray examinations evaluating the quality of reports and potential contributions to clinical decision-making. Methods We acquired both standard free text and structured reports of 31 patients with a painful shoulder without history of previous trauma who received X-ray exams. A template was created for the structured report based on the template ID 0000154 (Shoulder X-ray) from radreport.org using online software with clickable decision trees with concomitant generation of structured semantic reports. All reports were evaluated regarding overall quality and key features: content, information extraction and clinical relevance. Results Two experienced orthopaedic surgeons reviewed and rated structured and free text reports of 31 patients independently. The structured reports achieved significantly higher median ratings in all key features evaluated (P < 0.001), including facilitation of information extraction (P < 0.001) and better contribution to subsequent clinical decision-making (P < 0.001). The overall quality of structured reports was significantly higher than in free text report (P < 0.001). Conclusions A comprehensive structured template may be a useful tool to assist in clinical decision-making and is, thus, recommended for the reporting of degenerative changes regarding X-ray examinations of the shoulder. Electronic supplementary material The online version of this article (10.1186/s12880-018-0262-8) contains supplementary material, which is available to authorized users.
Collapse
|
56
|
Management-Based Structured Reporting of Posttreatment Glioma Response With the Brain Tumor Reporting and Data System. J Am Coll Radiol 2018; 15:767-771. [DOI: 10.1016/j.jacr.2018.01.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 01/11/2018] [Accepted: 01/15/2018] [Indexed: 01/24/2023]
|
57
|
Martí-Bonmatí L, Ruiz-Martínez E, Ten A, Alberich-Bayarri A. Cómo integrar la información cuantitativa en el informe radiológico del paciente oncológico. RADIOLOGIA 2018. [DOI: 10.1016/j.rx.2018.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
58
|
Vilanova J. Claves del informe radiológico en oncología. RADIOLOGIA 2018. [DOI: 10.1016/j.rx.2018.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
59
|
Lee RK, Cerniglia B, Reilly T. Using auto population of X-ray procedure exam type in radiology reports to decrease reporting errors. Clin Imaging 2018; 50:208-210. [PMID: 29660531 DOI: 10.1016/j.clinimag.2018.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 03/20/2018] [Accepted: 04/05/2018] [Indexed: 01/15/2023]
Affiliation(s)
- Ryan K Lee
- Department of Radiology, Einstein Healthcare Network, 5501 Old York Rd, Gr. Fl. Levy Bldg, Philadelphia, PA 19141, United States.
| | - Brett Cerniglia
- Department of Radiology, Einstein Healthcare Network, United States
| | - Thomas Reilly
- Department of Radiology, Einstein Healthcare Network, United States
| |
Collapse
|
60
|
Johnson TF, Brinjikji W, Doolittle DA, Nagelschneider AA, Welch BT, Kotsenas AL. Structured Head and Neck CT Angiography Reporting Reduces Resident Revision Rates. Curr Probl Diagn Radiol 2018; 48:114-116. [PMID: 29753407 DOI: 10.1067/j.cpradiol.2018.04.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 04/06/2018] [Accepted: 04/09/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE This resident-driven quality improvement project was undertaken to assess the effectiveness of structured reporting to reduce revision rates for afterhours reports dictated by residents. METHODS The first part of the study assessed baseline revision rates for head and neck CT angiography (CTA) examinations dictated by residents during afterhours call. A structured report was subsequently created based on templates on the RSNA informatics reporting website and critical findings that should be assessed for on all CTA examinations. The template was made available to residents through the speech recognition software for all head and neck CTA examinations for a duration of 2 months. Report revision rates were then compared with and without use of the structured template. RESULTS The structured template was found to reduce revision rates by approximately 50% with 10/41 unstructured reports revised and 2/17 structured reports revised. CONCLUSIONS We believe that structured reporting can help reduce reporting errors, particularly in term of typographical errors, train residents to evaluate complex examinations in a systematic fashion, and assist them in recalling critical findings on these examinations.
Collapse
|
61
|
Sabel BO, Plum JL, Czihal M, Lottspeich C, Schönleben F, Gäbel G, Schinner R, Schoeppe F, Meinel FG. Structured Reporting of CT Angiography Runoff Examinations of the Lower Extremities. Eur J Vasc Endovasc Surg 2018; 55:679-687. [PMID: 29627139 DOI: 10.1016/j.ejvs.2018.01.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 01/27/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The aim was to evaluate the effect of structured reporting of computed tomography angiography (CTA) runoff studies on clarity, completeness, clinical relevance, usefulness of the radiology reports, further testing, and therapy in patients with known or suspected peripheral arterial disease. METHODS Conventional reports (CRs) and structured reports (SRs) were generated for 52 patients who had been examined with a CTA runoff examination of the lower extremities. The sample size was based on power calculations with a power of 95% and a significance level of .007 (adjusted for multiple testing). CRs were dictated in a free text form; SRs contained a consistent ordering of observations with standardised subheadings. CRs were compared with SRs. Two vascular medicine specialists and two vascular surgeons rated the reports regarding their satisfaction with clarity, completeness, clinical relevance, and usefulness as well as overall satisfaction. Additionally, they made hypothetical decisions on further testing and therapy. Median ratings were compared using the Wilcoxon signed rank test and generalised linear mixed effects models. RESULTS SRs received higher ratings for satisfaction with clarity (median rating 9.0 vs. 7.0, p < .0001) and completeness (median rating 9.0 vs. 7.5, p < .0001) and were judged to be of greater clinical relevance (median rating 9.0 vs. 8.0, p < .0001) and usefulness (median rating 9.0 vs. 8.0, p < .0001). Overall satisfaction was also higher for SRs (median rating 9.0 vs. 7.0, p < .0001) than CRs. There were no significant differences in further testing or therapy. CONCLUSION Referring clinicians perceive SRs of CTA runoff examinations of the lower extremities as offering superior clarity, completeness, clinical relevance, and usefulness than CRs. Structured reporting does not appear to alter further testing or therapy in patients with known or suspected peripheral arterial disease.
Collapse
Affiliation(s)
- Bastian O Sabel
- Department of Radiology, University Hospital, LMU Munich, Germany.
| | - Jessica L Plum
- Department of Radiology, University Hospital, LMU Munich, Germany
| | - Michael Czihal
- Division of Vascular Medicine, Medical Clinic and Policlinic IV, Hospital of the Ludwig-Maximilians-University, Munich, Germany
| | - Christian Lottspeich
- Division of Vascular Medicine, Medical Clinic and Policlinic IV, Hospital of the Ludwig-Maximilians-University, Munich, Germany
| | - Frank Schönleben
- Department of Vascular and Endovascular Surgery, Ludwig-Maximilians-University, Munich, Germany
| | - Gabor Gäbel
- Department of Vascular and Endovascular Surgery, Ludwig-Maximilians-University, Munich, Germany
| | - Regina Schinner
- Department of Radiology, University Hospital, LMU Munich, Germany
| | | | - Felix G Meinel
- Department of Radiology, University Hospital, LMU Munich, Germany; Department of Diagnostic and Interventional Radiology, Rostock University Medical Centre, Rostock, Germany
| |
Collapse
|
62
|
Structured Reporting of Multiphasic CT for Hepatocellular Carcinoma: Effect on Staging and Suitability for Transplant. AJR Am J Roentgenol 2018; 210:766-774. [DOI: 10.2214/ajr.17.18725] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
63
|
Radiology Reporting: Current Practices and an Introduction to Patient-Centered Opportunities for Improvement. AJR Am J Roentgenol 2018; 210:376-385. [DOI: 10.2214/ajr.17.18721] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
64
|
Structured Reporting in Radiology. Acad Radiol 2018; 25:66-73. [PMID: 29030284 DOI: 10.1016/j.acra.2017.08.005] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/02/2017] [Accepted: 08/03/2017] [Indexed: 11/20/2022]
Abstract
Radiology reports are vital for patient care as referring physicians depend upon them for deciding appropriate patient management. Traditional narrative reports are associated with excessive variability in the language, length, and style, which can minimize report clarity and make it difficult for referring clinicians to identify key information needed for patient care. Structured reporting has been advocated as a potential solution for improving the quality of radiology reports. The Association of University Radiologists-Radiology Research Alliance Structured Reporting Task Force convened to explore the current and future role of structured reporting in radiology and summarized its finding in this article. We review the advantages and disadvantages of structured radiology reports and discuss the current prevailing sentiments among radiologists regarding structured reports. We also discuss the obstacles to the use of structured reports and highlight ways to overcome some of those challenges. We also discuss the future directions in radiology reporting in the era of personalized medicine.
Collapse
|
65
|
A Comparison of Radiologists' and Urologists' Opinions Regarding Prostate MRI Reporting: Results From a Survey of Specialty Societies. AJR Am J Roentgenol 2018; 210:101-107. [DOI: 10.2214/ajr.17.18241] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
66
|
Franconeri A, Fang J, Carney B, Justaniah A, Miller L, Hur HC, King LP, Alammari R, Faintuch S, Mortele KJ, Brook OR. Structured vs narrative reporting of pelvic MRI for fibroids: clarity and impact on treatment planning. Eur Radiol 2017; 28:3009-3017. [PMID: 29247353 DOI: 10.1007/s00330-017-5161-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/19/2017] [Accepted: 10/27/2017] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To evaluate clarity and usefulness of MRI reporting of uterine fibroids using a structured disease-specific template vs. narrative reporting for planning of fibroid treatment by gynaecologists and interventional radiologists. METHODS This is a HIPAA-compliant, IRB-approved study with waiver of informed consent. A structured reporting template for fibroid MRIs was developed in collaboration between gynaecologists, interventional and diagnostic radiologists. The study population included 29 consecutive women who underwent myomectomy for fibroids and pelvic MRI prior to implementation of structured reporting, and 42 consecutive women with MRI after implementation of structured reporting. Subjective evaluation (on a scale of 1-10, 0 not helpful; 10 extremely helpful) and objective evaluation for the presence of 19 key features were performed. RESULTS More key features were absent in the narrative reports 7.3 ± 2.5 (range 3-12) than in structured reports 1.2 ± 1.5 (range 1-7), (p < 0.0001). Compared to narrative reports, gynaecologists and radiologists deemed structured reports both more helpful for surgical planning (p < 0.0001) (gynaecologists: 8.5 ± 1.2 vs. 5.7 ± 2.2; radiologists: 9.6 ± 0.6 vs. 6.0 ± 2.9) and easier to understand (p < 0.0001) (gynaecologists: 8.9 ± 1.1 vs. 5.8 ± 1.9; radiologists: 9.4 ± 1.3 vs. 6.3 ± 1.8). CONCLUSION Structured fibroid MRI reports miss fewer key features than narrative reports. Moreover, structured reports were described as more helpful for treatment planning and easier to understand. KEY POINTS • Structured reports missed only 1.2 ± 1.5 out of 19 key features, as compared to narrative reports that missed 7.3 ± 2.5 key features for planning of fibroid treatment. • Structured reports were more helpful and easier to understand by clinicians. • Structured template can provide essential information for fibroids treatment planning.
Collapse
Affiliation(s)
- Andrea Franconeri
- Department of Radiology, IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100, Pavia, Italy
| | - Jieming Fang
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Benjamin Carney
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Almamoon Justaniah
- Department of Radiology, King Abdulla Medical City, Makkah, Saudi Arabia
| | - Laura Miller
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Hye-Chun Hur
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Louise P King
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Roa Alammari
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Salomao Faintuch
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Koenraad J Mortele
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Olga R Brook
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA.
| |
Collapse
|
67
|
Structured Reporting of Rectal Magnetic Resonance Imaging in Suspected Primary Rectal Cancer: Potential Benefits for Surgical Planning and Interdisciplinary Communication. Invest Radiol 2017; 52:232-239. [PMID: 27861230 DOI: 10.1097/rli.0000000000000336] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the effect of structured reports (SRs) in comparison to nonstructured, free-text (FT) rectal magnetic resonance imaging (MRI) reports in patients with histologically proven rectal cancer and potential effects of both types of reporting on referring surgeons' satisfaction, interdisciplinary communication, and further clinical decision making. MATERIALS AND METHODS The institutional review board approved this retrospective study with waiver of informed consent. Forty-nine patients with histologically proven rectal cancer were included in this study. All patients underwent rectal MRI for local rectal cancer staging before surgery. Free-text reports and SRs for local MR staging of rectal cancer were generated for all subjects by radiologists. Two experienced abdominal surgeons evaluated a questionnaire that included 9 questions regarding satisfaction with content, presence of reported key features, effort for information extraction, and report quality. RESULTS Structured reports achieved significantly higher satisfaction rates with report content and clarity, and included significantly more of the 13 predefined key features compared with FT reports (SRs: mean ± SD, 12.2 ± 4.6 [range, 9-13] versus FT reports: mean ± SD, 9.2 ± 10.8 [range, 5-13]) (P < 0.001). Definite further clinical decision making (surgery vs neoadjuvant radiochemotherapy) was possible in 96% of SRs and only in 60% of FT reports (P < 0.001). In case of surgery, the reported information was considered to be sufficient for surgical planning in 94% of SRs versus only 38% in FT reports (P < 0.001). Structured report received a significantly higher overall report quality rated on a Likert scale from 1 to 6 (1, insufficient; 6, excellent) with a mean of 5.8 ± 0.42 (range, 5-6) in comparison to FT reports with 3.6 ± 1.19 (range, 1-5) (P < 0.001). CONCLUSIONS Structured reporting of rectal MRI in patients with rectal cancer facilitates surgical planning and leads to a higher satisfaction level of referring surgeons in comparison to FT reports. Abdominal surgeons were more confident about report correctness and further clinical decision making on the basis of SRs.
Collapse
|
68
|
Ross SL, Ascher SM, Somwaru AS, Filice R. Quantifying Language Before and After Instituting Structured CT Reports. J Am Coll Radiol 2017. [DOI: 10.1016/j.jacr.2017.04.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
69
|
An audit comparing the reporting of staging MRI scans for rectal cancer with the London Cancer Alliance (LCA) guidelines. Eur J Surg Oncol 2017; 43:2093-2104. [DOI: 10.1016/j.ejso.2017.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 06/30/2017] [Accepted: 09/01/2017] [Indexed: 02/06/2023] Open
|
70
|
Radiology report "disclaimers" increase the use of abdominal CT in the work-up of pediatric abdominal pain. Am J Emerg Med 2017; 36:556-559. [PMID: 28982533 DOI: 10.1016/j.ajem.2017.09.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 09/05/2017] [Accepted: 09/13/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Pediatric abdominal pain is commonly evaluated in the emergency department (ED) initially by ultrasonography (U/S). Radiology reports often include commentary about U/S limitations and possible need for additional testing or evaluation independent of study interpretation. We sought to determine if presence of a "disclaimer" is associated with additional imaging. METHODS Design: Retrospective cohort. SETTING Community ED with volume of 85,000 annual visits. POPULATION Consecutive ED patients <21-years-old with appendix U/S over 12-months. Radiologist reports were assessed for disclaimers and if definitive diagnoses of appendicitis were made. The incidence of subsequent CT imaging was determined and group differences between categories were calculated. RESULTS 441 eligible patients were identified with average age 11.7years. Of all U/S studies, 26% were definitive for appendicitis and 74% were non-definitive. Disclaimers were included on 60% of all studies, including 13% of definitive studies and 76% of non-definitive studies. 25% of all studies including a disclaimer had follow-up CT versus 10% of studies without a disclaimer (15% difference; 95% CI: 9-21). For patients with definitive interpretations, 6% had follow-up CT with no significant difference between groups with or without a disclaimer. For patients with non-definitive studies, 26% with a disclaimer had follow-up CT scans versus 13% without a disclaimer (13% difference; 95% CI: 4-22). CONCLUSIONS Appendix ultrasound interpretations often include a disclaimer, which leads to a 150% increase in follow-up CT imaging. We suggest that radiologists consider the impact of including such a disclaimer, knowing that this may contribute to possible unnecessary imaging.
Collapse
|
71
|
Wildman-Tobriner B, Allen BC, Bashir MR, Camp M, Miller C, Fiorillo LE, Cubre A, Javadi S, Bibbey AD, Ehieli WL, McGreal N, Quevedo R, Thacker JK, Mazurowski M, Jaffe TA. Structured reporting of CT enterography for inflammatory bowel disease: effect on key feature reporting, accuracy across training levels, and subjective assessment of disease by referring physicians. Abdom Radiol (NY) 2017; 42:2243-2250. [PMID: 28393301 DOI: 10.1007/s00261-017-1136-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE To compare the content and accuracy of structured reporting (SR) versus non-structured reporting (NSR) for computed tomographic enterography (CTE) of inflammatory bowel disease (IBD). MATERIALS AND METHODS This IRB-approved, HIPAA-compliant, retrospective study included 30 adult subjects (15 male, 15 female; mean age 41.9 years) with IBD imaged with CTE. Nine radiologists (3 faculty, 3 abdominal imaging fellows, and 3 senior radiology residents) independently interpreted all examinations using both NSR and SR, separated by four weeks. Reports were assessed for documentation of 15 key reporting features and a subset of 5 features was assessed for accuracy. Thirty faculty reports (15 NSR [5 per reader] and 15 SR [5 per reader]) were randomly selected for review by three referring physicians, who independently rated quality metrics for each report. RESULTS NSR documented the presence or absence of 8.2 ± 2.2 key features, while SR documented 14.6 ± 0.5 features (p < 0.001). SR resulted in increased documentation of 13 of 15 features including stricture (p < 0.001), fistula (p < 0.001), fluid collection (p = 0.003), and perianal disease (p < 0.001). Among a subset of five features, accuracy for diagnosing multifocal disease was minimally increased when using SR (76% NSR vs. 83% SR; p = 0.01), but accuracy for other features was not affected by report type. Referring physicians significantly preferred SR based on ease of information extraction (p < 0.01). CONCLUSION Structured reporting of CTE for IBD improved documentation of key reporting features for trainees and faculty, though there was minimal impact on accuracy. Referring physicians subjectively preferred the structured reports.
Collapse
|
72
|
Golder WA. Interpretation and Diplomacy Aspects of Authority and Care in Imaging Reports. J Digit Imaging 2017; 31:5-8. [PMID: 28808802 DOI: 10.1007/s10278-017-0014-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Whereas the creativity and intellectual power of the radiologist are measured against his/her written report, the value of the message will not only be judged by the precision of the medical statement. The same result can be attributed to different words. Numerous common and accidental factors exert influence on the decision on what is said and what is not said, how it is assessed and what is ignored. The less certain a diagnosis is and the less favourable its possible consequences are, the more subtleties and periphrases are to be expected within the report. The decision on the nature and the volume of the written report will not only be taken by the time of recording, but is likewise prepared by the knowledge of the patient's history and symptoms, the personal relationship to him/her as well as by a set of conditions throughout the inspection of the images. The intuition that accompanies the information transfer in imaging diagnostics does not only explain the differences in volume and depth of diagnosis and differential diagnosis, but also the range of diagnostic and therapeutic recommendations.
Collapse
Affiliation(s)
- Werner A Golder
- Association d'Imagerie Médicale, Avignon, 23, rue de l'Oriflamme, 84000, Avignon, France.
| |
Collapse
|
73
|
Lee B, Whitehead MT. Radiology Reports: What YOU Think You’re Saying and What THEY Think You’re Saying. Curr Probl Diagn Radiol 2017; 46:186-195. [DOI: 10.1067/j.cpradiol.2016.11.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/06/2016] [Accepted: 11/08/2016] [Indexed: 11/22/2022]
|
74
|
Sabel BO, Plum JL, Kneidinger N, Leuschner G, Koletzko L, Raziorrouh B, Schinner R, Kunz WG, Schoeppe F, Thierfelder KM, Sommer WH, Meinel FG. Structured reporting of CT examinations in acute pulmonary embolism. J Cardiovasc Comput Tomogr 2017; 11:188-195. [DOI: 10.1016/j.jcct.2017.02.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/14/2017] [Accepted: 02/19/2017] [Indexed: 02/04/2023]
|
75
|
Strategies for Improving the Value of the Radiology Report: A Retrospective Analysis of Errors in Formally Over-read Studies. J Am Coll Radiol 2017; 14:459-466. [DOI: 10.1016/j.jacr.2016.08.033] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 08/29/2016] [Accepted: 08/30/2016] [Indexed: 11/20/2022]
|
76
|
Gassenmaier S, Armbruster M, Haasters F, Helfen T, Henzler T, Alibek S, Pförringer D, Sommer WH, Sommer NN. Structured reporting of MRI of the shoulder - improvement of report quality? Eur Radiol 2017; 27:4110-4119. [PMID: 28289942 DOI: 10.1007/s00330-017-4778-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 02/03/2017] [Accepted: 02/13/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To evaluate the effect of structured reports (SRs) in comparison to non-structured narrative free text (NRs) shoulder MRI reports and potential effects of both types of reporting on completeness, readability, linguistic quality and referring surgeons' satisfaction. METHODS Thirty patients after trauma or with suspected degenerative changes of the shoulder were included in this study (2012-2015). All patients underwent shoulder MRI for further assessment and possible surgical planning. NRs were generated during clinical routine. Corresponding SRs were created using a dedicated template. All 60 reports were evaluated by two experienced orthopaedic shoulder surgeons using a questionnaire that included eight questions. RESULTS Eighty per cent of the SRs were fully complete without any missing key features whereas only 45% of the NRs were fully complete (p < 0.001). The extraction of information was regarded to be easy in 92% of the SRs and 63% of the NRs. The overall quality of the SRs was rated better than that of the NRs (p < 0.001). CONCLUSIONS Structured reporting of shoulder MRI improves the readability as well as the linguistic quality of radiological reports, and potentially leads to a higher satisfaction of referring physicians. KEY POINTS • Structured MRI reports of the shoulder improve readability. • Structured reporting facilitates information extraction. • Referring physicians prefer structured reports to narrative free text reports. • Structured MRI reports of the shoulder can reduce radiologist re-consultations.
Collapse
Affiliation(s)
- Sebastian Gassenmaier
- Department of Clinical Radiology, Ludwig-Maximilians-University (LMU), Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany.
| | - Marco Armbruster
- Department of Clinical Radiology, Ludwig-Maximilians-University (LMU), Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
| | - Florian Haasters
- Department of Knee, Hip and Shoulder Surgery, Schön Klinik München Harlaching, Munich, Germany
- Department of General, Trauma and Reconstructive Surgery, Ludwig-Maximilians-University (LMU), Campus Innenstadt, Munich, Germany
| | - Tobias Helfen
- Department of General, Trauma and Reconstructive Surgery, Ludwig-Maximilians-University (LMU), Campus Innenstadt, Munich, Germany
| | - Thomas Henzler
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany
| | - Sedat Alibek
- Ambulatory Health Care Center Radiology & Nuclear Medicine, Fürth, Germany
- Department of Diagnostic Radiology, Friedrich-Alexander University, Erlangen-Nuremberg, Germany
| | - Dominik Pförringer
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Wieland H Sommer
- Department of Clinical Radiology, Ludwig-Maximilians-University (LMU), Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
| | - Nora N Sommer
- Department of Clinical Radiology, Ludwig-Maximilians-University (LMU), Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
| |
Collapse
|
77
|
Dickerson E, Davenport MS, Syed F, Stuve O, Cohen JA, Rinker JR, Goldman MD, Segal BM, Foerster BR. Effect of Template Reporting of Brain MRIs for Multiple Sclerosis on Report Thoroughness and Neurologist-Rated Quality: Results of a Prospective Quality Improvement Project. J Am Coll Radiol 2017; 14:371-379.e1. [DOI: 10.1016/j.jacr.2016.09.037] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 09/05/2016] [Accepted: 09/19/2016] [Indexed: 11/30/2022]
|
78
|
Affinity Chart Analysis: A Method for Structured Collection, Aggregation, and Response to Customer Needs in Radiology. AJR Am J Roentgenol 2017; 208:W134-W145. [PMID: 28140618 DOI: 10.2214/ajr.16.16673] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of this study is to analyze implementation of the voice-of-the-customer method to assess the current state of image postprocessing and reporting delivered by a radiology department and to plan improvements on the basis of referring physicians' preferences. SUBJECTS AND METHODS The voice-of-the-customer method consisted of discovery, analysis, and optimization phases. Fifty referring physicians were invited to be interviewed. Interviews addressed the topics of structure, process, outcome, and support. Interviews were dissected into individual statements categorized as fact or feeling. Statements were grouped to find collective voices. Improvements were compiled from affinity charts and were processed by identifying insights. RESULTS Ninety-four percent (47/50) of physicians participated, generating 352 statements (81 facts and 271 feelings) that subsequently underwent affinity chart clustering. The resultant affinity charts covered distinct themes: "we need you to know us better," "we need you to consider our workflow," "we need more from your services," "we want to review your data in certain ways," and "we want to do more with you." As a result of the insights gained, the following optimizations were implemented: a software application that improves study requesting, performance tracking, study prioritization, and longitudinal data archiving; six prototype reports containing tabulated data and annotated images; two prototype longitudinal reporting templates assessing aneurysm evolution and treatment-induced changes in organ size over time; and a teaching curriculum for trainees. CONCLUSION This study has shown the clinical feasibility to assess the current state of image postprocessing and reporting and to implement improvements of and investments in image postprocessing and reporting infrastructure on the basis of referring physicians' preferences using the voice-of-the-customer method.
Collapse
|
79
|
Patel BN, Lopez JM, Jiang BG, Roth CJ, Nelson RC. Image-Rich Radiology Reports: A Value-Based Model to Improve Clinical Workflow. J Am Coll Radiol 2017; 14:57-64. [DOI: 10.1016/j.jacr.2016.07.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 07/15/2016] [Accepted: 07/19/2016] [Indexed: 12/16/2022]
|
80
|
Goldberg-Stein S, Walter WR, Amis ES, Scheinfeld MH. Implementing a Structured Reporting Initiative Using a Collaborative Multistep Approach. Curr Probl Diagn Radiol 2016; 46:295-299. [PMID: 28104315 DOI: 10.1067/j.cpradiol.2016.12.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 12/04/2016] [Accepted: 12/10/2016] [Indexed: 11/22/2022]
Abstract
PURPOSE To describe the successful implementation of a structured reporting initiative in a large urban academic radiology department. METHODS We describe our process, compromises, and top 10 lessons learned in overhauling traditional reporting practices and comprehensively implementing structured reporting at our institution. To achieve our goals, we took deliberate steps toward consensus building, undertook multistep template refinement, and achieved close collaboration with the technical staff, department coders, and hospital information technologists. Following institutional review board exemption, we audited radiologist compliance by evaluating 100 consecutive cases of 12 common examination types. Fisher exact test was applied to determine significance of association between trainee initial report drafting and template compliance. RESULTS We produced and implemented structured reporting templates for 95% of all departmental computed tomography, magnetic resonance, and ultrasound examinations. Structured templates include specialized reports adhering to the American College of Radiology's Reporting and Data Systems (ACR's RADS) recommendations (eg, Lung-RADS and Li-RADS). We attained 94% radiologist compliance within 2 years, without any financial incentives. CONCLUSIONS We provide a blueprint of how to successfully achieve structured reporting using a collaborative multistep approach.
Collapse
Affiliation(s)
- Shlomit Goldberg-Stein
- Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY.
| | - William R Walter
- Department of Radiology, NYU Langone Medical Center, New York, NY
| | - E Stephen Amis
- Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
| | - Meir H Scheinfeld
- Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
| |
Collapse
|
81
|
Gunn AJ, Tuttle MC, Flores EJ, Mangano MD, Bennett SE, Sahani DV, Choy G, Boland GW. Differing Interpretations of Report Terminology Between Primary Care Physicians and Radiologists. J Am Coll Radiol 2016; 13:1525-1529.e1. [DOI: 10.1016/j.jacr.2016.07.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/14/2016] [Accepted: 07/19/2016] [Indexed: 12/01/2022]
|
82
|
McWilliams JP, Shah RP, Quirk M, White SB, Dybul SL, Ahrar J, Steele JR, Kwan SW, Handel J, Winokur RS, Gilliland CA, Durack JC. Standardized Reporting in IR: A Prospective Multi-Institutional Pilot Study. J Vasc Interv Radiol 2016; 27:1779-1785. [PMID: 27670943 DOI: 10.1016/j.jvir.2016.07.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 07/15/2016] [Accepted: 07/15/2016] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To assess adoption and survey-based satisfaction rates following deployment of standardized interventional radiology (IR) procedure reports across multiple institutions. MATERIALS AND METHODS Standardized reporting templates for 5 common interventional procedures (central venous access, inferior vena cava [IVC] filter insertion, IVC filter removal, uterine artery embolization, and vertebral augmentation) were distributed to 20 IR practices in a prospective quality-improvement study. Participating sites edited the reports according to institutional preferences and deployed them for a 1-year pilot study concluding in July 2015. Study compliance was measured by sampling 20 reports of each procedure type at each institution, and surveys of interventionalists and referring physicians were performed. Modifications to the standardized reporting templates at each site were analyzed. RESULTS Ten institutions deployed the standardized reports, with 8 achieving deployment of 3-12 months. The mean report usage rate was 57%. Each site modified the original reports, with 26% mean reduction in length, 18% mean reduction in wordiness, and 60% mean reduction in the number of forced fill-in fields requiring user input. Linear-regression analysis revealed that reduced number of forced fill-in fields correlated significantly with increased usage rate (R2 = 0.444; P = .05). Surveys revealed high satisfaction rates among referring physicians but lower satisfaction rates among interventional radiologists. CONCLUSIONS Standardized report adoption rates increased when reports were simplified by reducing the number of forced fill-in fields. Referring physicians preferred the standardized reports, whereas interventional radiologists preferred standard narrative reports.
Collapse
Affiliation(s)
- Justin P McWilliams
- Department of Radiology, Division of Interventional Radiology, Ronald Reagan University of California, Los Angeles (UCLA), Medical Center, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, 2nd Floor, Suite 2125C, Los Angeles, CA 90095.
| | - Rajesh P Shah
- Department of Radiology, Division of Interventional Radiology, Ronald Reagan University of California, Los Angeles (UCLA), Medical Center, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, 2nd Floor, Suite 2125C, Los Angeles, CA 90095
| | - Matthew Quirk
- Department of Radiology, Division of Interventional Radiology, Ronald Reagan University of California, Los Angeles (UCLA), Medical Center, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, 2nd Floor, Suite 2125C, Los Angeles, CA 90095
| | - Sarah B White
- Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Stephanie L Dybul
- Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Judy Ahrar
- Division of Diagnostic Imaging, Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Joseph R Steele
- Division of Diagnostic Imaging, Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sharon W Kwan
- Department of Radiology, Section of Interventional Radiology, University of Washington Medical Center, Seattle, Washington
| | - Jeremy Handel
- Department of Diagnostic Radiology and Molecular Imaging, Section of Interventional Radiology, Beaumont Health, Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Ronald S Winokur
- Department of Radiology, Division of Interventional Radiology, Weill Cornell/New York Presbyterian Hospital, New York, New York
| | - Charles A Gilliland
- Division of Interventional Radiology and Image Guided Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Jeremy C Durack
- Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, New York, New York
| |
Collapse
|
83
|
Dlamini N, Goodier M. Adequacy of ultrasound reports in patients presenting with obstructive jaundice at a tertiary hospital radiology department. SA J Radiol 2016. [DOI: 10.4102/sajr.v20i1.1034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Patients with obstructive jaundice require a stepwise approach to investigation and management. Ultrasound (US) is the initial screening modality of choice and has been shown to be accurate in demonstrating the presence of dilated bile ducts, as well as the level and cause of obstruction. For adequate radiological communication to the clinician, degree of bile duct dilatation, level of obstruction, appearance of the transition zone and cause of obstruction must be reported. However, without a structured reporting method, much of this information may be omitted.Objectives: The aim of the study was to investigate the adequacy of US findings in patients with obstructive jaundice, as documented, without standardised reporting.Methods: A retrospective chart review of 130 US reports of adult patients presenting at Grey’s Hospital US Department with a clinical assessment of obstructive jaundice was conducted. Data for the period January to December 2013, were analysed. US reports of patients with dilated bile ducts were assessed for report adequacy by looking at four important clinical factors, that is, the degree of bile duct dilatation, the level of obstruction, the appearance of the transition zone and the cause of the obstruction.Results: A report adequacy score was assessed in 79 patients with dilated bile ducts; however, two reports were excluded because of obscuration by gas. There was a high level of report inadequacy (38%) without the use of a structured reporting template. The level of obstruction was the most common component missing from the reports (25%), followed by the appearance of the transition zone (18%) and cause of obstruction (12%).Conclusion: We propose the use of an US report template for obstructive jaundice patients in order to ensure comprehensive reporting. Structured radiological reporting will improve the method of communication between clinicians and radiologists, thus improving the quality of patient care.
Collapse
|
84
|
Soldatos T, Pezeshk P, Ezzati F, Karp DR, Taurog JD, Chhabra A. Cross-sectional imaging of adult crystal and inflammatory arthropathies. Skeletal Radiol 2016; 45:1173-91. [PMID: 27209200 DOI: 10.1007/s00256-016-2402-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 04/27/2016] [Accepted: 04/28/2016] [Indexed: 02/02/2023]
Abstract
This article highlights the key aspects and current perspectives of the role of cross-sectional imaging in adult crystal and inflammatory arthropathies in adults, briefly discussing CT, and particularly focusing on MRI and US imaging as it supplements the conventional radiography. The role of conventional and advanced MR imaging techniques and imaging findings in this domain is discussed and illustrated with case examples. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article contains images and data, which were collected from patients as a part of a retrospective IRB from the institutional teaching files and informed consent was waived.
Collapse
Affiliation(s)
| | - Parham Pezeshk
- Musculoskeletal Radiology and Orthopaedic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9178, USA
| | - Fatemeh Ezzati
- Division of Rheumatic Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - David R Karp
- Division of Rheumatic Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Joel D Taurog
- Division of Rheumatic Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Avneesh Chhabra
- Musculoskeletal Radiology and Orthopaedic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9178, USA. .,Musculoskeletal Radiology, Russell H. Morgan Department of Radiology & Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| |
Collapse
|
85
|
Hanna TN, Shekhani H, Maddu K, Zhang C, Chen Z, Johnson JO. Structured report compliance: effect on audio dictation time, report length, and total radiologist study time. Emerg Radiol 2016; 23:449-53. [PMID: 27344141 DOI: 10.1007/s10140-016-1418-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 06/20/2016] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to examine structured template use among emergency radiologists, and if this influences audio dictation time, radiology report length, or total radiologist study time. Retrospective data collection of consecutive occurrences of seven common imaging examinations interpreted by a dedicated emergency radiology division over a 2-month period yielded 3449 reports. Templates had been in place for >3 years. For each examination, we documented the individual audio dictation time (ADT), total words, and total time the radiologist spent on a study from report creation until final signing. In 81.2 % (n = 2772) of all cases, a basic template was used. In 2.8 % (n = 78) of these template-use cases, the radiologist removed key elements from the structured template. Of the 3417 reports with complete data, mean ADT was 37.3 s, mean word length was 132.3 (of which, on average, 64 were dictated), and total radiologist time per study (TRT) was 349.7 s. Study type was significantly associated with ADT, total words, and TRT (p < 0.001). Template usage decreased ADT (p < 0.001) by 47 %, but did not affect total word length or TRT. Parameters varied by individual attending (p < 0.001): 20 % (2/10) of attendings had differences in report length when using versus not using templates (p < 0.001). With long-term template usage, compliance with structured templates is high, and few radiologists significantly alter the templates. Template use decreases ADT and for a small fraction of radiologists impacts total word length and has a mixed impact on TRT.
Collapse
Affiliation(s)
- Tarek N Hanna
- Division of Emergency Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, 30322, USA.
| | - Haris Shekhani
- Division of Emergency Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Kiran Maddu
- Division of Emergency Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Chao Zhang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Zhengjia Chen
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Jamlik-Omari Johnson
- Division of Emergency Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, 30322, USA
| |
Collapse
|
86
|
Al-Safadi L. The Effects of Real-Time Interactive Multimedia Teleradiology System. BIOMED RESEARCH INTERNATIONAL 2016; 2016:4126841. [PMID: 27294118 PMCID: PMC4886096 DOI: 10.1155/2016/4126841] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 04/03/2016] [Accepted: 04/26/2016] [Indexed: 11/17/2022]
Abstract
This study describes the design of a real-time interactive multimedia teleradiology system and assesses how the system is used by referring physicians in point-of-care situations and supports or hinders aspects of physician-radiologist interaction. We developed a real-time multimedia teleradiology management system that automates the transfer of images and radiologists' reports and surveyed physicians to triangulate the findings and to verify the realism and results of the experiment. The web-based survey was delivered to 150 physicians from a range of specialties. The survey was completed by 72% of physicians. Data showed a correlation between rich interactivity, satisfaction, and effectiveness. The results of our experiments suggest that real-time multimedia teleradiology systems are valued by referring physicians and may have the potential for enhancing their practice and improving patient care and highlight the critical role of multimedia technologies to provide real-time multimode interactivity in current medical care.
Collapse
Affiliation(s)
- Lilac Al-Safadi
- Department of Information Technology, College of Computer and Information Sciences, King Saud University, Saudi Arabia
| |
Collapse
|
87
|
Abstract
The goal of a diagnostic imaging examination is to provide the referring provider with an actionable imaging report that can be used to impart information to determine optimal clinical management for the patient. An actionable imaging report not only conveys the findings of the examination accurately, but does so in a timely and safe manner for an imaging examination that was performed appropriately and using the correct technique. The use of information technology tools has been paramount in improving the value of the imaging report and continues to play a prominent role in this process. The diversity of abdominal imaging, in both the variety of imaging modalities available and the organ systems evaluated, makes it well-suited to adopt these information technology solutions to improve report quality, including increased consistency in reports and in follow-up recommendations. This review discusses the components of the imaging chain involved in optimizing the imaging report with specific emphasis on the role of information technology applications to address the challenges that are frequently encountered. Specific abdominal imaging examples are presented to provide practical guidance and clinical context.
Collapse
|
88
|
Optimization of Radiology Reports for Intensive Care Unit Portable Chest Radiographs. J Thorac Imaging 2016; 31:43-8. [DOI: 10.1097/rti.0000000000000165] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
89
|
The Value of Imaging Part II: Value beyond Image Interpretation. Acad Radiol 2016; 23:23-9. [PMID: 26683509 DOI: 10.1016/j.acra.2015.09.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/09/2015] [Accepted: 09/20/2015] [Indexed: 12/21/2022]
Abstract
Although image interpretation is an essential part of radiologists' value, there are other ways in which we contribute to patient care. Part II of the value of imaging series reviews current initiatives that demonstrate value beyond the image interpretation. Standardizing processes, reducing the radiation dose of our examinations, clarifying written reports, improving communications with patients and providers, and promoting appropriate imaging through decision support are all ways we can provide safer, more consistent, and higher quality care. As payers and policy makers push to drive value, research that demonstrates the value of these endeavors, or lack thereof, will become increasingly sought after and supported.
Collapse
|
90
|
Weissman A, Solano M, Taeymans O, Holmes SP, Jiménez D, Barton B. A SURVEY OF RADIOLOGISTS AND REFERRING VETERINARIANS REGARDING IMAGING REPORTS. Vet Radiol Ultrasound 2015; 57:124-9. [DOI: 10.1111/vru.12310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 08/29/2015] [Indexed: 11/26/2022] Open
Affiliation(s)
- Andrea Weissman
- Department of Clinical Sciences, Cummings School of Veterinary; Tufts University; North Grafton MA 01536
| | - Mauricio Solano
- Department of Clinical Sciences, Cummings School of Veterinary; Tufts University; North Grafton MA 01536
| | | | - Shannon P. Holmes
- Department of Veterinary Biosciences and Diagnostic Imaging; The University of Georgia; Athens GA 30602
| | - David Jiménez
- Department of Veterinary Biosciences and Diagnostic Imaging; The University of Georgia; Athens GA 30602
| | - Bruce Barton
- Department of Quantitative Health Sciences; University of Massachusetts Medical School; Worcester MA 01655
| |
Collapse
|
91
|
Association Between Confidence Level of Acute Pulmonary Embolism Diagnosis on CTPA images and Clinical Outcomes. Acad Radiol 2015; 22:1555-61. [PMID: 26391859 DOI: 10.1016/j.acra.2015.08.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 07/22/2015] [Accepted: 08/23/2015] [Indexed: 11/24/2022]
Abstract
RATIONALE AND OBJECTIVES The purpose was to evaluate clinical characteristics associated with low confidence in diagnosis of acute pulmonary embolism (PE) as expressed in computed tomography pulmonary angiography (CTPA) reports and to evaluate the effect of confidence level in PE diagnosis on patient clinical outcomes. MATERIALS AND METHODS This study included radiology reports from 1664 consecutive CTPA considered positive for acute PE (8/2003-5/2010). All reports were retrospectively assessed for the level of confidence in diagnosis. Baseline characteristics and outcomes (therapies related to PE and short-term mortality) were compared between high and low confidence groups. Multivariable logistic and Cox regression analyses were used to analyze the relationship between the confidence level and outcomes. RESULTS One-hundred sixty of 1664 (9.6%) reports had language that reflected a low confidence in PE diagnosis. The low confidence group had smaller (segmental and subsegmental) suspected emboli (prevalence, 72.5% vs. 50.7%; P < .001) and more comorbidities. The low confidence group had a lower likelihood of receiving PE-related therapies (adjusted odds ratio [OR], 0.18; 95% confidence interval, 0.10-031, P < .001), but there was no change in the all-cause and PE-related 30-day and/or 90-day mortality (OR of death for low confidence, 0.81-1.13, P values > .5). CONCLUSIONS Roughly 10% of positive CTPA reports had uncertainty in PE findings, and patients with reports categorized as low confidence had smaller emboli and more comorbidities. Although the low confidence group was less likely to receive PE-related therapies, patients in this group were not associated with higher probability of short-term mortality.
Collapse
|
92
|
Impact of a Structured Report Template on the Quality of MRI Reports for Rectal Cancer Staging. AJR Am J Roentgenol 2015; 205:584-8. [PMID: 26295645 DOI: 10.2214/ajr.14.14053] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study is to assess the impact of implementing a structured report template on the quality of MRI reports for rectal cancer staging. MATERIALS AND METHODS After excluding examinations performed after surgery or neoadjuvant therapy, we analyzed all rectal cancer staging MRI reports finalized at an academic medical center 12 months before and after an intervention consisting of implementing a structured report template integrated into the institution's speech recognition system. The primary outcome measure was the quality of rectal cancer staging MRI reports classified as optimal, satisfactory, or unsatisfactory, on the basis of the documentation of 14 quality measures predefined by a consensus of the institution's abdominal radiology subspecialists. Chi-square and t tests were used to assess differences in report quality and documentation of each discrete quality measure before and after the intervention. RESULTS The study cohort included 106 MRI reports from 104 patients (mean age, 60 years; 58.5% male); 52 (49.1%) of the reports were completed before implementation of the structured report template. After implementation, the proportion of total reports classified as optimal or satisfactory increased from 38.5% (20/52) to 70.4% (38/54) (p = 0.0010). No reports generated before the intervention were classified as optimal, whereas 40.7% (22/54) of reports were classified as optimal after the intervention. CONCLUSION Implementation and voluntary use of a structured report template improved the quality of MRI reports for rectal cancer staging compared with free-text format.
Collapse
|
93
|
Bharwani N, Tirlapur SA, Balogun M, Priest L, Khan KS, Zamora J, Sahdev A. MRI reporting standard for chronic pelvic pain: consensus development. Br J Radiol 2015; 89:20140615. [PMID: 26562496 DOI: 10.1259/bjr.20140615] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
AIM To identify radiological parameters that should be reported on gynaecological MRI in order to create a standardized assessment pro forma for reporting CPP, which may be used in clinical practice. METHODS Chronic pelvic pain (CPP) in females is a common problem presenting a major challenge to healthcare providers. The complex multifactorial aetiology requires a multidisciplinary approach and often necessitates diagnostic laparoscopy for assessment. MRI is emerging as a potential non-invasive alternative for evaluation of CPP; however, standardization of reporting is required for it to be used in routine clinical practice. A two-generational Delphi survey with an expert panel of 28 radiologists specializing in gynaecological MRI from across the UK was used to refine a proposed reporting template for CPP. RESULTS 75% response rate for the first round and 79% for the second. Following the second round, agreement was reached on the structure of the pro forma and the way in which information was sought, with overall consistency of agreement between experts deemed as fair (intraclass correlation coefficient = 0.394). This was accepted as the final version by consensus. CONCLUSION The standardized pro forma developed in this study will form the basis for future prospective evaluation of MRI in CPP. This template could be modified for the assessment of other benign gynaecological conditions. ADVANCES IN KNOWLEDGE Female CPP is a significant problem presenting challenges for clinicians. MRI is often used for evaluation and standardization of techniques, and reporting is required. The pro forma developed in this study will form the basis for future prospective MRI evaluation.
Collapse
Affiliation(s)
- Nishat Bharwani
- 1 Department of Radiology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Seema A Tirlapur
- 2 Women's Health Research Unit, Queen Mary, University of London, London, UK
| | - Moji Balogun
- 3 Department of Radiology, Birmingham Women's Hospital, Birmingham, UK
| | - Lee Priest
- 4 Birmingham Clinical Trials Unit (BCTU), Institute for Applied Health Research, Public Health Building, University of Birmingham, Birmingham, UK
| | - Khalid S Khan
- 2 Women's Health Research Unit, Queen Mary, University of London, London, UK.,5 Department of Obstetrics and Gynaecology, Barts Health NHS Trust, The Royal London Hospital, London, UK
| | - Javier Zamora
- 6 Clinical Biostatistics Unit, Hospital Ramon y Cajal (IRYCIS), CIBERESP, Madrid, Spain
| | - Anju Sahdev
- 7 Department of Imaging, Ground Floor, KGV Wing, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, UK
| |
Collapse
|
94
|
Hwang DH, Ma K, Yepes F, Nadamuni M, Nayyar M, Liu B, Duddalwar V, Lepore N. Multidimensional Interactive Radiology Report and Analysis: Standardization of workflow and reporting for renal mass tracking and quantification. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2015; 9681:96810C. [PMID: 31178621 PMCID: PMC6554203 DOI: 10.1117/12.2211526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A conventional radiology report primarily consists of a large amount of unstructured text, and lacks clear, concise, consistent and content-rich information. Hence, an area of unmet clinical need consists of developing better ways to communicate radiology findings and information specific to each patient. Here, we design a new workflow and reporting system that combines and integrates advances in engineering technology with those from the medical sciences, the Multidimensional Interactive Radiology Report and Analysis (MIRRA). Until recently, clinical standards have primarily relied on 2D images for the purpose of measurement, but with the advent of 3D processing, many of the manually measured metrics can be automated, leading to better reproducibility and less subjective measurement placement. Hence, we make use this newly available 3D processing in our workflow. Our pipeline is used here to standardize the labeling, tracking, and quantifying of metrics for renal masses.
Collapse
Affiliation(s)
- Darryl H Hwang
- USC 4D Quantitative Imaging Lab, Dept. of Radiology, Univ. of Southern California, Los Angeles, CA, USA 90033
| | - Kevin Ma
- Dept. of Biomedical Engineering, Univ. of Southern California, Los Angeles, CA, USA 90089
| | - Fernando Yepes
- CIBORG Laboratory, Dept. of Radiology, Children's Hospital Los Angeles, CA, USA 90027
| | - Mridula Nadamuni
- Dept. of Radiology, Univ. of Southern California, Los Angeles, CA, USA 90033
| | - Megha Nayyar
- Dept. of Radiology, Univ. of Southern California, Los Angeles, CA, USA 90033
| | - Brent Liu
- Dept. of Biomedical Engineering, Univ. of Southern California, Los Angeles, CA, USA 90089
| | - Vinay Duddalwar
- Dept. of Radiology, Univ. of Southern California, Los Angeles, CA, USA 90033
| | - Natasha Lepore
- CIBORG Laboratory, Dept. of Radiology, Children's Hospital Los Angeles, CA, USA 90027
| |
Collapse
|
95
|
Tran L, Wadhwa A, Mann E. Implementation of Structured Radiology Reports. J Am Coll Radiol 2015; 13:296-9. [PMID: 26410349 DOI: 10.1016/j.jacr.2015.06.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 06/28/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Leanne Tran
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Anupma Wadhwa
- Division of Infectious Diseases, Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Erika Mann
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada.
| |
Collapse
|
96
|
Pietryga JA, Morgan DE. Imaging preoperatively for pancreatic adenocarcinoma. J Gastrointest Oncol 2015; 6:343-57. [PMID: 26261722 DOI: 10.3978/j.issn.2078-6891.2015.024] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 01/22/2015] [Indexed: 12/22/2022] Open
Abstract
Pancreatic cancer is a highly lethal malignancy which is increasing in incidence and mortality. The fourth leading cause of cancer death in the U.S., pancreatic cancer is projected to become the second leading cause of cancer death by 2020. Patients with pancreatic cancer have an abysmal 5-year survival of 6%, and 90% of these patients eventually die from the disease. This is in large part due to the commonly advanced stage of disease at the time of diagnosis. Currently, the only potentially curative therapy for pancreatic carcinoma is complete surgical resection. Patients who undergo incomplete resection with residual disease have similar survival rates to those patients with metastatic disease and should be spared this relatively morbid surgery. Thus, the key to impacting prognosis is the detection of smaller and earlier stage lesions, and the key to optimal management is accurately determining which patients have potentially resectable surgery and which patients would not benefit from surgery. Cross-sectional imaging plays an essential role in both the diagnosis and appropriate staging of pancreatic carcinoma. The diagnosis and staging of pancreatic adenocarcinoma is performed with cross-sectional imaging. Multi-detector computed tomography (MDCT) is the most commonly used, best-validated imaging modality for the diagnosis and staging of pancreatic cancer. Modern contrast-enhanced magnetic resonance imaging (MRI) has been demonstrated to be equivalent to MDCT in detection and staging of pancreatic cancer. Endoscopic ultrasound (EUS) is very sensitive for detecting pancreatic masses; however, due to limitations in adequate overall abdominal staging, it is generally used in addition to or after MDCT. Transabdominal ultrasound and positron emission tomography/computed tomography (PET/CT) have limited roles in the diagnosis and staging of pancreatic cancer. Preoperative imaging is used to characterize patients as having resectable disease, borderline resectable disease, locally advanced disease (unresectable) and metastatic disease (unresectable). As the definitions of borderline resectable and unresectable may vary from institution to institution and within institutions, it is essential to accurately assess and describe the factors relevant to staging including: local extent of tumor, vascular involvement, lymph node involvement and distant metastatic disease. To facilitate this, standardized reporting templates for pancreatic ductal adenocarcinoma have been created and published. Structured reporting for pancreatic cancer has been reported to provide superior evaluation of pancreatic cancer, facilitate surgical planning, and increase surgeons' confidence about tumor resectability.
Collapse
Affiliation(s)
- Jason Alan Pietryga
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Desiree E Morgan
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| |
Collapse
|
97
|
Lin E, Powell DK, Kagetsu NJ. Efficacy of a checklist-style structured radiology reporting template in reducing resident misses on cervical spine computed tomography examinations. J Digit Imaging 2015; 27:588-93. [PMID: 24865860 DOI: 10.1007/s10278-014-9703-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The increasing use of medical checklists to promote patient safety raises the question of their utility in diagnostic radiology. This study evaluates the efficacy of a checklist-style reporting template in reducing resident misses on cervical spine CT examinations. A checklist-style reporting template for cervical spine CTs was created at our institution and mandated for resident preliminary reports. Ten months after implementation of the template, we performed a retrospective cohort study comparing rates of emergent pathology missed on reports generated with and without the checklist-style reporting template. In 1,832 reports generated without using the checklist-style template, 25 (17.6%) out of 142 emergent findings were missed. In 1,081 reports generated using the checklist-style template, 13 (11.9%) out of 109 emergent findings were missed. The decrease in missed pathology was not statistically significant (p = 0.21). However, larger differences were noted in the detection of emergent non-fracture findings, with 17 (28.3%) out of 60 findings missed on reports without use of the checklist template and 5 (9.3%) out of 54 findings missed on reports using the checklist template, representing a statistically significant decrease in missed non-fracture findings (p = 0.01). The use of a checklist-style structured reporting template resulted in a statistically significant decrease in missed non-fracture findings on cervical spine CTs. The lack of statistically significant change in missed fractures was expected given that residents' search patterns naturally include fracture detection. Our findings suggest that the use of checklists in structured reporting may increase diagnostic accuracy.
Collapse
Affiliation(s)
- Eaton Lin
- Department of Radiology, St. Luke's Roosevelt Hospital Center, 1000 10th Ave, Rm 4C-12, New York, NY, 10019, USA,
| | | | | |
Collapse
|
98
|
Fatahi N, Krupic F, Hellström M. Quality of radiologists' communication with other clinicians--As experienced by radiologists. PATIENT EDUCATION AND COUNSELING 2015; 98:722-727. [PMID: 25766732 DOI: 10.1016/j.pec.2015.02.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Revised: 01/29/2015] [Accepted: 02/07/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The objective was to study radiologists' experiences of written and oral communication with referring clinicians, and its potential implications for decision making and patient care. METHODS Focus group discussions with 12 radiologists were carried out. Content analysis was used for interpretation of the data. RESULTS Radiologists reported many problems with the request forms: improper choice of imaging examinations and procedures, insufficient patient history/information, unclear clinical questions, lack of specific terms and unclear abbreviations on the request form. Radiologists also mentioned other difficulties: insufficient attention among participating clinicians during conferences, difficulties in reaching the referring clinicians by telephone, and communication difficulties in making priorities between patients. To overcome these problems, radiologists suggested increased contacts between radiologists and clinicians, and educational activities. CONCLUSION A number of difficulties in oral and written communication were highlighted. The use of medical imaging may be optimized by joint discussions on indications and methodology and educational activities, such as lectures, seminars and conferences, directed to the medical community at large. PRACTICE IMPLICATIONS Improved communication between radiologists and referring clinicians should be encouraged to ensure diagnostic quality, correct patient prioritization and patient safety, and to avoid unnecessary delays and costs.
Collapse
Affiliation(s)
- Nabi Fatahi
- Department of Radiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ferid Krupic
- Department of Orthopedics, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mikael Hellström
- Department of Radiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| |
Collapse
|
99
|
Manoonchai N, Kaewlai R, Wibulpolprasert A, Boonpramarn U, Tohmee A, Phongkitkarun S. Satisfaction of imaging report rendered in emergency setting: a survey of radiology and referring physicians. Acad Radiol 2015; 22:760-70. [PMID: 25754801 DOI: 10.1016/j.acra.2015.01.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 01/10/2015] [Accepted: 01/15/2015] [Indexed: 11/30/2022]
Abstract
RATIONALE AND OBJECTIVES To determine physicians' preference toward three types of structured imaging reports (basic structured report [BSR], itemized report [IR], and point-and-click report [PCR]) used in emergency radiology. MATERIALS AND METHODS Survey questions were created and considered valid and reliable based on index of item objective congruence from three specialists (>0.75) and a pilot of 25 subjects (Cronbach alpha, 0.83-1.00). Respondents included trainees and attendings in radiology and referring physicians working in the academic emergency department at the time of survey rollout. They were provided report examples of each type and asked to complete a questionnaire consisting of the following five parts: demographics, necessity of imaging report, report quality (content, format and organization, and language), process of reporting, and components of imaging report. For rating scores, the higher value means the higher preference and agreement. RESULTS The survey received 79.5% response rate. Respondents included 101 physicians (mean age, 29.4 years; 61 radiology physicians and 40 referring physicians; 81 trainees and 20 attending). Overall, IR was preferred over PCR and BSR by all physicians with scores (out of 10) as follows: IR, 7.62-8.83; PCR, 6.62-8.55; BSR, 5.23-6.65; P < .001. IR received scores (out of 5) of 4.03-4.37, PCR 3.32-4.52, and BSR 2.59-3.86 for report quality. For process of reporting, IR had scores (out of 5) of 3.80-4.56, PCR 2.79-4.09, and BSR 2.32-3.56. CONCLUSIONS In emergency setting, physicians preferred IR over PCR and BSR. IR and PCR were equal in report quality metrics, but IR was most preferred in the process of reporting. BSR ranked last in both quality and process.
Collapse
Affiliation(s)
- Naree Manoonchai
- Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, 270, Rama VI road, Ratchathewi, Bangkok 10400, Thailand
| | - Rathachai Kaewlai
- Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, 270, Rama VI road, Ratchathewi, Bangkok 10400, Thailand.
| | - Arrug Wibulpolprasert
- Department of Emergency Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ugrit Boonpramarn
- Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, 270, Rama VI road, Ratchathewi, Bangkok 10400, Thailand
| | - Adul Tohmee
- Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, 270, Rama VI road, Ratchathewi, Bangkok 10400, Thailand
| | - Sith Phongkitkarun
- Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, 270, Rama VI road, Ratchathewi, Bangkok 10400, Thailand
| |
Collapse
|
100
|
Hempel JM, Pinto dos Santos D, Kloeckner R, Dueber C, Mildenberger P. [Reporting initiatives. An update on treatment in radiology]. Radiologe 2015; 54:696-9. [PMID: 24989877 DOI: 10.1007/s00117-014-2681-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The written radiological report is the most important means of communication between the radiologist and the referring medical doctor. There is no universal definition of a radiological report concerning its structure and content. The majority of clinicians and radiologists prefer structured reporting rather than free text reports of findings. Structured reporting does not increase the quality of a radiological report but has many advantages in research, teaching and quality management. Using standard RadLex terms facilitates translation and ontological assignment of a report. The Reporting Initiative of the Radiological Society of North America (RSNA) offers free and freely available extensively validated best practices radiology report templates in the new management of radiology report templates (MRRT) format according to the guidelines of the Integrating the Healthcare Enterprise (IHE).
Collapse
Affiliation(s)
- J-M Hempel
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland,
| | | | | | | | | |
Collapse
|