Perception of radiology reporting efficacy by neurologists in general and university hospitals

PRECISE framework: Enhanced radiology reporting with GPT for improved readability, reliability, and patient-centered care

BACKGROUND

The PRECISE framework, defined as Patient-Focused Radiology Reports with Enhanced Clarity and Informative Summaries for Effective Communication, leverages GPT-4 to create patient-friendly summaries of radiology reports at a sixth-grade reading level.

PURPOSE

The purpose of the study was to evaluate the effectiveness of the PRECISE framework in improving the readability, reliability, and understandability of radiology reports. We hypothesized that the PRECISE framework improves the readability and patient understanding of radiology reports compared to the original versions.

MATERIALS AND METHODS

The PRECISE framework was assessed using 500 chest X-ray reports. Readability was evaluated using the Flesch Reading Ease, Gunning Fog Index, and Automated Readability Index. Reliability was gauged by clinical volunteers, while understandability was assessed by non-medical volunteers. Statistical analyses including t-tests, regression analyses, and Mann-Whitney U tests were conducted to determine the significance of the differences in readability scores between the original and PRECISE-generated reports.

RESULTS

Readability scores significantly improved, with the mean Flesch Reading Ease score increasing from 38.28 to 80.82 (p-value < 0.001), the Gunning Fog Index decreasing from 13.04 to 6.99 (p-value < 0.001), and the ARI score improving from 13.33 to 5.86 (p-value < 0.001). Clinical volunteer assessments found 95 % of the summaries reliable, and non-medical volunteers rated 97 % of the PRECISE-generated summaries as fully understandable.

CONCLUSION

The application of the PRECISE approach demonstrates promise in enhancing patient understanding and communication without adding significant burden to radiologists. With improved reliability and patient-friendly summaries, this approach holds promise for fostering patient engagement and understanding in healthcare decision-making. The PRECISE framework represents a pivotal step towards more inclusive and patient-centric care delivery.

Education Research: Neuroradiology Curriculum and Competencies Among Canadian Adult Neurology Residency Programs: A Cross-Sectional Study

Background and Objectives

While benefitting from neuroradiologists' reports, neurologists use their own image interpretation to guide clinical decisions, especially in acute care settings. This calls for robust neuroradiology training in neurology residency, informed by current educational gaps and practices. This study aims to (1) characterize the formal neuroradiology curriculum among Canadian neurology residency programs; (2) assess neurology residents' neuroimaging interpretation competencies; and (3) define neurology residents' and program directors' (PDs) attitudes toward the current curriculum and future directions.

Methods

Anonymous surveys were sent to Canadian neurology residents and PDs, querying neuroradiology learning activities, imaging modalities covered, assessment modalities, perceived residents' competencies to interpret different modalities, and attitudes regarding neuroradiology training. Residents were asked to interpret 15 neuroimaging cases. Descriptive and inferential analyses were performed. Potential differences in residents' interpretation success rates by seniority, self-perceived proficiency, and perception of curriculum sufficiency were examined using 2-tailed Welch tests with a 95% CI and Holm-Bonferroni comparison adjustment. Statistics were computed using Excel.

Results

Seventy-eight (32.6%) residents and 11 (68.8%) PDs participated. Ten of 11 PDs reported including a mandatory neuroradiology rotation, and 9/11 offered a formal neuroradiology curriculum covering head CT, head and neck CT angiography (CTA), spine MRI, and head MRI. Programs predominantly offered additional didactic lectures (9/11), teaching cases (8/11), and imaging websites (8/11). Most of the residents agreed with a minimum 1-month long rotation and desired regular didactics from neuroradiologists. Residents favored learning about head MRI (88.5%), head and neck CTA (76.9%), and spine MRI (69.2%). Senior residents' self-perceived competencies were highest for head CT, head MRI, and head and neck CTA, but lower than PDs' perception. Senior residents had greater interpretation scores than juniors (84.5% ± 13.2% vs 69.1% ± 19.9%; p < 0.0001). Most PDs (7/11, 63.6%) expressed satisfaction with current curricula vs 32.1% of residents. PDs identified time and educator shortages as main barriers to increased training.

Discussion

Neuroradiology training varies among programs. Residents expressed strong interest in commonly taught modalities, for which they also expressed high self-perceived competencies. However, PDs expressed greater satisfaction than residents with the current training. Leveraging interactions with neuroradiologists and online case-based learning while emphasizing trainees' interests can enhance postgraduate neuroradiology training for this useful skill.

Designing a Consumer-Friendly Radiology Report using a Patient-Centered Approach

Patient portals have helped accelerate patient engagement in treatment. Patient understanding of radiology reports has become a necessity, and we are working to design a patient-friendly radiology report that can be easily understood. We have based the design of this new radiology report on the results of a previous study that examined patient desires and needs by exploring their questions posted on online discussion forums. The current design was tested by presenting it in two groups, a control group, and an intervention group. In our evaluation, we relied on the following five concepts: understanding (quiz), cosmetics appearance, perceived ease of use, acceptance, and preference. The results showed that the new design outperformed the current design in all five concepts with an overall of (P < .00). Based on these results, we have determined that the radiology report should include both an image and notes section, and the design can be applied to all types of radiological examinations using various imaging devices. We believe this design will be an important building block in facilitating patient understanding of radiology reports.

Understanding patient needs and gaps in radiology reports through online discussion forum analysis

Our objective is to investigate patient needs and understand information gaps in radiology reports using patient questions that were posted on online discussion forums. We leveraged online question and answer platforms to collect questions posted by patients to understand current gaps and patient needs. We retrieved six hundred fifty-nine (659) questions using the following sites: Yahoo Answers, Reddit.com, Quora, and Wiki Answers. The questions retrieved were analyzed and the major themes and topics were identified. The questions retrieved were classified into eight major themes. The themes were related to the following topics: radiology report, safety, price, preparation, procedure, meaning, medical staff, and patient portal. Among the 659 questions, 35.50% were concerned with the radiology report. The most common question topics in the radiology report focused on patient understanding of the radiology report (62 of 234 [26.49%]), image visualization (53 of 234 [22.64%]), and report representation (46 of 234 [19.65%]). We also found that most patients were concerned about understanding the MRI report (32%; n = 143) compared with the other imaging modalities (n = 434). Using online discussion forums, we discussed major unmet patient needs and information gaps in radiology reports. These issues could be improved to enhance radiology design in the future.

Am I Ready to Be an Independent Neuroradiologist? Objective Trends in Neuroradiology Fellows' Performance during the Fellowship Year

BACKGROUND AND PURPOSE

Aside from basic Accreditation Council for Graduate Medical Education guidelines, few metrics are in place to monitor fellows' progress. The purpose of this study was to determine objective trends in neuroradiology fellowship training on-call performance during an academic year.

MATERIALS AND METHODS

We retrospectively reviewed the number of cross-sectional neuroimaging studies dictated with complete reports by neuroradiology fellows during independent call. Monthly trends in total call cases, report turnaround times, relationships between volume and report turnaround times, and words addended to preliminary reports by attending neuroradiologists were evaluated with regression models. Monthly variation in frequencies of call-discrepancy macros were assessed via χ² tests. Changes in frequencies of specific macro use between fellowship semesters were assessed via serial 2-sample tests of proportions.

RESULTS

From 2012 to 2017, for 29 fellows, monthly median report turnaround times significantly decreased during the academic year: July (first month) = 79 minutes (95% CI, 71-86 minutes) and June (12th month) = 55 minutes (95% CI, 52-60 minutes; P value = .023). Monthly report turnaround times were inversely correlated with total volumes for CT (r = -0.70, F = 9.639, P value = .011) but not MR imaging. Words addended to preliminary reports, a surrogate measurement of report clarity, slightly improved and discrepancy rates decreased during the last 6 months of fellowship. A nadir for report turnaround times, discrepancy errors, and words addended to reports was seen in December and January.

CONCLUSIONS

Progress through fellowship correlates with a decline in report turnaround times and discrepancy rates for cross-sectional neuroimaging call studies and slight improvement in indirect quantitative measurement of report clarity. These metrics can be tracked throughout the academic year, and the midyear would be a logical time point for programs to assess objective progress of fellows and address any deficiencies.