1
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Lasrich M, Helling K, Strieth S, Bahr-Hamm K, Vogt TJ, Fröhlich L, Send T, Hill K, Nitsch L, Rader T, Bärhold F, Becker S, Ernst BP. [Increased report completeness and satisfaction with structured neurotological reporting in the interdisciplinary assessment of vertigo]. HNO 2024:10.1007/s00106-024-01464-5. [PMID: 38592481 DOI: 10.1007/s00106-024-01464-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Results of neurotological function diagnostics in the context of interdisciplinary vertigo assessment are usually formulated as free-text reports (FTR). These are often subject to high variability, which may lead to loss of information. The aim of the present study was to evaluate the completeness of structured reports (SR) and referrer satisfaction in the neurotological assessment of vertigo. MATERIALS AND METHODS Neurotological function diagnostics performed as referrals (n = 88) were evaluated retrospectively. On the basis of the available raw data, SRs corresponding to FTRs from clinical routine were created by means of a specific SR template for neurotological function diagnostics. FTRs and SRs were evaluated for completeness and referring physician satisfaction (n = 8) using a visual analog scale (VAS) questionnaire. RESULTS Compared to FTRs, SRs showed significantly increased overall completeness (73.7% vs. 51.7%, p < 0.001), especially in terms of patient history (92.5% vs. 66.7%, p < 0.001), description of previous findings (87.5% vs. 38%, p < 0.001), and neurotological (33.5% vs. 26.7%, p < 0.001) and audiometric function diagnostics (58% vs. 32.3%, p < 0.001). In addition, SR showed significantly increased referring physician satisfaction (VAS 8.8 vs. 4.9, p < 0.001). CONCLUSION Neurotological SRs enable a significantly increased report completeness with higher referrer satisfaction in the context of interdisciplinary assessment of vertigo. Furthermore, SRs are particularly suitable for scientific data analysis, especially in the context of big data analyses.
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Affiliation(s)
- M Lasrich
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Bonn, Bonn, Deutschland
| | - K Helling
- Hals‑, Nasen‑, Ohrenklinik und Poliklinik - Plastische Operationen, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - S Strieth
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Bonn, Bonn, Deutschland
| | - K Bahr-Hamm
- Hals‑, Nasen‑, Ohrenklinik und Poliklinik - Plastische Operationen, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - T J Vogt
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Bonn, Bonn, Deutschland
| | - L Fröhlich
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Bonn, Bonn, Deutschland
| | - T Send
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Bonn, Bonn, Deutschland
| | - K Hill
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - L Nitsch
- Klinik und Poliklinik für Neurologie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - T Rader
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Abteilung Audiologie, LMU Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland
| | - F Bärhold
- Nasen- und Ohrenheilkunde, Universitätsklinikum Tübingen, Universitätsklinik für Hals-, Tübingen, Deutschland
| | - S Becker
- Nasen- und Ohrenheilkunde, Universitätsklinikum Tübingen, Universitätsklinik für Hals-, Tübingen, Deutschland
| | - B P Ernst
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Deutschland.
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2
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Fanni SC, Romei C, Ferrando G, Volpi F, D’Amore CA, Bedini C, Ubbiali S, Valentino S, Neri E. Natural language processing to convert unstructured COVID-19 chest-CT reports into structured reports. Eur J Radiol Open 2023; 11:100512. [PMID: 37575311 PMCID: PMC10413059 DOI: 10.1016/j.ejro.2023.100512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 08/15/2023] Open
Abstract
Background Structured reporting has been demonstrated to increase report completeness and to reduce error rate, also enabling data mining of radiological reports. Still, structured reporting is perceived by radiologists as a fragmented reporting style, limiting their freedom of expression. Purpose A deep learning-based natural language processing method was developed to automatically convert unstructured COVID-19 chest CT reports into structured reports. Methods Two hundred-two COVID-19 chest CT were retrospectively reviewed by two experienced radiologists, who wrote for each exam a free-form text radiological report and coherently filled the template provided by the Italian Society of Medical and Interventional Radiology, used as ground-truth. A semi-supervised convolutional neural network was implemented to extract 62 categorical variables from the report. Two iterations were carried-out, the first without fine-tuning, the second one performing a fine-tuning. The performance was measured using the mean accuracy and the F1 mean score. An error analysis was performed to identify errors entirely attributable to incorrect processing of the model. Results The algorithm achieved a mean accuracy of 93.7% and an F1 score 93.8% in the first iteration. Most of the errors were exclusively attributable to wrong inference (46%). In the second iteration the model achieved for both parameters 95,8% and percentage of errors attributable to wrong inference decreased to 26%. Conclusions The convolutional neural network achieved an optimal performance in the automated conversion of free-form text into structured radiological reports, overcoming all the limitation attributed to structured reporting and finally paving the way for data mining of radiological report.
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Affiliation(s)
| | - Chiara Romei
- Department of Diagnostic Imaging, 2nd Radiology Unit, Pisa University-Hospital, Pisa, Italy
| | | | - Federica Volpi
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | - Caterina Aida D’Amore
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
| | | | - Sandro Ubbiali
- EBIT sr.l. Esaote Group, Via di Caciolle, Florence, Italy
| | | | - Emanuele Neri
- Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy
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3
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Seyedhasani SN, Dorri S, Pournik O, Alamdaran SA, Eslami S. Improving data adequacy of ultrasonography reports for non-alcoholic fatty liver disease (NAFLD) through a national structured template. Acta Radiol 2023; 64:473-478. [PMID: 35538852 DOI: 10.1177/02841851221093141] [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: 11/16/2022]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is a prevalent disorder that increases due to lifestyle, the rising rate of obesity, and population ages worldwide. Diagnostic ways, including sonography, do not have an explicit reporting structure. PURPOSE To create a structure template for NAFLD reporting, investigate its completeness, and assess the specialist opinions of using it in clinical practice. MATERIAL AND METHODS A structured reporting template (SRT) was designed and implemented in four stages. At first, important features were extracted from a comprehensive literature review and were evaluated by 10 radiologists and gastroenterologists using the Likert scale. Finally, the usefulness of the SRT in comparison with the conventional reporting template (CRT) was judged by 10 gastroenterologists completing the questionnaire. RESULTS Demographic information and sonography of the liver, gallbladder, and spleen organs were the most critical features. The completeness scores of SRT reports were higher than CRT scores for almost all the factors studied. The difference in the scores was significant for most of the parameters. Moreover, the total completeness score increased from 42% in CRT to 92% in SRT. A comparison of the report adequacy of two reports was seen in all items. The SRT obtained more rates from specialists. CONCLUSION Introduction of the SRT for NAFLD significantly enhanced the completeness of reporting to reduce variability in the interpretation of the related reports by clinicians. Nevertheless, more studies are needed to generalize the results in real scales for patients with NAFLD.
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Affiliation(s)
- Seyedeh Nahid Seyedhasani
- Department of Health Information Technology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Health Sciences Research Center, 435810Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Sara Dorri
- Health Information Technology Research Center, 48455Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Pournik
- Department of Community Medicine, School of Medicine, 440827Iran University of Medical Sciences, Tehran, Iran
| | | | - Saeid Eslami
- Department of Medical Informatics, School of Medicine, 37552Mashhad University of Medical Sciences, Mashhad, Iran
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4
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Ernst BP, Dörsching C, Bozzato A, Gabrielpillai J, Becker S, Froelich MF, Kramer B, Sproll C, Schapher M, Goncalves M, Mansour N, Hofauer B, Sommer WH, von Scotti F, Weimer JM, Künzel J. Structured Reporting of Head and Neck Sonography Achieves Substantial Interrater Reliability. Ultrasound Int Open 2023; 9:E26-E32. [PMID: 37808417 PMCID: PMC10556873 DOI: 10.1055/a-2173-3966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 08/14/2023] [Indexed: 10/10/2023] Open
Abstract
Purpose Ultrasound examinations are often criticized for having higher examiner dependency compared to other imaging techniques. Compared to free-text reporting, structured reporting (SR) of head and neck sonography (HNS) achieves superior time efficiency as well as report quality. However, there are no findings concerning the influence of SR on the interrater reliability (IRR) of HNS. Materials and Methods Typical pathologies (n=4) in HNS were documented by video/images by two certified head and neck ultrasound instructors. Consequently, structured reports of these videos/images were created by n=9 senior physicians at departments of otolaryngology or maxillofacial surgery with DEGUM instructors on staff. Reports (n=36) were evaluated regarding overall completeness and IRR. Additionally, user satisfaction was assessed by a visual analog scale (VAS). Results SR yielded very high report completeness (91.8%) in all four cases with a substantial IRR (Fleiss' κ 0.73). Interrater agreement was high at 87.2% with very good user satisfaction (VAS 8.6). Conclusion SR has the potential to ensure high-quality examination reports with substantial comparability and very high user satisfaction. Furthermore, big data collection and analysis are facilitated by SR. Therefore, process quality, workflow, and scientific output are potentially enhanced by SR.
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Affiliation(s)
| | - Carla Dörsching
- Department of Otorhinolaryngology, University Medical Center Bonn,
Bonn, Germany
| | - Alessandro Bozzato
- Department of Otorhinolaryngology, Head & Neck Surgery,
Saarland University Hospital and Saarland University Faculty of Medicine,
Homburg, Germany
| | - Jennis Gabrielpillai
- Department of Otorhinolaryngology, University Medical Center Bonn,
Bonn, Germany
| | - Sven Becker
- Department of Otorhinolaryngology, Head and Neck Surgery, University of
Tübingen Medical Center, Tuebingen, Germany
| | - Matthias Frank Froelich
- Department of Radiology and Nuclear Medicine, University Medical Centre
Mannheim, Mannheim, Germany
| | - Benedikt Kramer
- Department of Otorhinolaryngology, Head and Neck Surgery, University
Medical Centre Mannheim, Mannheim, Germany
| | - Christoph Sproll
- Department of Oral and Maxillofacial Surgery, Medical Faculty and
University Hospital Düsseldorf, Duesseldorf, Germany
| | - Mirco Schapher
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus
Medical University, Nuremberg, Germany
| | - Miguel Goncalves
- Department of Otorhinolaryngology, Plastic Head and Neck Surgery, RWTH
Aachen University Hospital, Aachen, Germany
| | - Naglaa Mansour
- Department of Otorhinolaryngology, University Medical Center Freiburg,
Freiburg, Germany
| | - Benedikt Hofauer
- Department of Otorhinolaryngology, Head and Neck Surgery, Technical
University of Munich Hospital Rechts der Isar, Munich, Germany
| | - Wieland H Sommer
- Department of Radiology, LMU University Hospital, Munich,
Germany
| | - Felix von Scotti
- Ultrasound Division, Otorhinolaryngology Center Münsterland,
Münster, Germany
| | - Johannes Matthias Weimer
- Rudolf-Frey Teaching Department, University Medical Center of the
Johannes Gutenberg University Mainz, Mainz, Germany
| | - Julian Künzel
- Department of Otorhinolaryngology, Universitätsklinikum
Regensburg, Regensburg, Germany
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5
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Todsen T, Ewertsen C, Jenssen C, Evans R, Kuenzel J. Head and Neck Ultrasound - EFSUMB Training Recommendations for the Practice of Medical Ultrasound in Europe. Ultrasound Int Open 2022; 8:E29-E34. [PMID: 36212171 PMCID: PMC9546639 DOI: 10.1055/a-1922-6778] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/27/2022] [Indexed: 11/07/2022] Open
Abstract
Different surgical and medical specialists increasingly use head and neck
ultrasound and ultrasound-guided interventions as part of their clinical
practice. We need to ensure high quality and standardized practice across
specialties, and this position paper of the European Federation of Societies for
Ultrasound in Medicine and Biology (EFSUMB) describes the training requirements
for head and neck ultrasound. Traditionally, a minimum number of ultrasound
examinations indicates competence, but this is unreliable, and a general shift
towards competence-based training is ongoing. For each EFSUMB level, we will
outline the theoretical knowledge and skills needed for clinical practice. The
recommendations follow the three EFSUMB competency levels for medical ultrasound
practice. Level 1 describes the skills required to perform essential head and
neck ultrasound examinations independently, level 2 includes ultrasound-guided
interventions, while level 3 involves the practice of high-level neck ultrasound
and use of advanced technologies. Our goal is to ensure high quality and
standardized head and neck ultrasound practice performed by different clinical
specialists with these recommendations.
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Affiliation(s)
- Tobias Todsen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology,
Rigshospitalet, Denmark,Copenhagen Academy for Medical Education and Simulation, University of
Copenhagen, and The Capital Region of Denmark, Copenhagen, Denmark,Department of Clinical Medicine, University of Copenhagen,
Denmark
| | - Caroline Ewertsen
- Department of Clinical Medicine, University of Copenhagen,
Denmark,Department of Radiology, Copenhagen University Hospital,
Rigshospitalet, Copenhagen, Denmark
| | - Christian Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland
GmbH, Strausberg, Germany,Brandenburg Institute for Clinical Ultrasound, Medical University
Brandenburg, Neuruppin, Germany
| | - Rhodri Evans
- Department of Radiology, Withybush General Hospital, Swansea, United
Kingdom of Great Britain and Northern Ireland
| | - Julian Kuenzel
- Department of Otorhinolaryngology, Head and Neck Surgery, University
Hospital Regensburg, Regensburg, Germany
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6
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Wüstner M, Radzina M, Calliada F, Cantisani V, Havre RF, Jenderka KV, Kabaalioğlu A, Kocian M, Kollmann C, Künzel J, Lim A, Maconi G, Mitkov V, Popescu A, Saftoiu A, Sidhu PS, Jenssen C. Professional Standards in Medical Ultrasound - EFSUMB Position Paper (Short Version) - General Aspects. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2022; 43:456-463. [PMID: 35850146 DOI: 10.1055/a-1854-2936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This first position paper of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) on professional standards presents a common position across the different medical professions within EFSUMB regarding optimal standards for the performing and reporting of ultrasound examinations by any professional ultrasound operator. It describes general aspects of professionality that ensure procedure quality, effectiveness, efficiency, and sustainability in virtually all application fields of medical ultrasound. Recommendations are given related to safety and indication of ultrasound examinations, requirements for examination rooms, structured examination, systematic reporting of results, and management, communication and archiving of ultrasound data. The print version of this article is a short version. The long version is published online.
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Affiliation(s)
- Matthias Wüstner
- Central Interdisciplinary Sonography, Krankenhaus der Barmherzigen Brüder, Trier, Germany
| | - Maija Radzina
- Radiology Research laboratory, Riga Stradins University, Riga, Latvia
- Diagnostic Radiology Institute, Paul Stradins Clinical University Hospital, Riga, Latvia
| | | | - Vito Cantisani
- Department of Radiology, "Sapienza" University of Rome, ROME, Italy
| | - Roald Flesland Havre
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | | | | | - Milan Kocian
- Anästhesie und Intensiv, Asklepios Klinik Burglengenfeld, Germany
- Visual Medicine s. r. o., Olomouc, Czech Republic
| | - Christian Kollmann
- Center for Medical Physics & Biomedical Engineering, Medical University Vienna, Austria
| | - Julian Künzel
- Otorhinolaryngology, University of Regensburg, Germany
| | - Adrian Lim
- Imaging, Imperial College, London, United Kingdom of Great Britain and Northern Ireland
| | - Giovanni Maconi
- Gastroenterology Unit, Department of Biomedical and Clinical Sciences, "L. Sacco" University Hospital, "L. Sacco" University Hospital, Milan, Italy
| | - Vladimir Mitkov
- Diagnostic Ultrasound Division, Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation
| | - Alina Popescu
- Gastroenterology, University of Medicine and Pharmacy Timisoara, Romania
| | - Adrian Saftoiu
- Res Ctr Gastroenterol Hepatol, University of Medicine and Pharmacy of Craiova, Romania
| | - Paul S Sidhu
- Radiology, King's College London, United Kingdom of Great Britain and Northern Ireland
| | - Christian Jenssen
- Klinik für Innere Medizin, Krankenhaus Märkisch Oderland Strausberg/Wriezen, Germany
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7
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Wüstner M, Radzina M, Calliada F, Cantisani V, Havre RF, Jenderka KV, Kabaalioğlu A, Kocian M, Kollmann C, Künzel J, Lim A, Maconi G, Mitkov V, Popescu A, Saftoiu A, Sidhu PS, Jenssen C. Professional Standards in Medical Ultrasound - EFSUMB Position Paper (Long Version) - General Aspects. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2022; 43:e36-e48. [PMID: 35850145 DOI: 10.1055/a-1857-4435] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This first position paper of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) on professional standards presents a common position across the different medical professions within EFSUMB regarding optimal standards for the performing and reporting of ultrasound examinations by any professional ultrasound operator. It describes general aspects of professionality that ensure procedure quality, effectiveness, efficiency, and sustainability in virtually all application fields of medical ultrasound. Recommendations are given related to safety and indication of ultrasound examinations, requirements for examination rooms, structured examination, systematic reporting of results, and management, communication and archiving of ultrasound data. The print version of this article is a short version. The long version is published online.
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Affiliation(s)
- Matthias Wüstner
- Central Interdisciplinary Sonography, Krankenhaus der Barmherzigen Brüder, Trier, Germany
| | - Maija Radzina
- Radiology Research laboratory, Riga Stradins University, Riga, Latvia
- Diagnostic Radiology Institute, Paul Stradins Clinical University Hospital, Riga, Latvia
| | | | - Vito Cantisani
- Department of Radiology, "Sapienza" University of Rome, ROME, Italy
| | - Roald Flesland Havre
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | | | | | - Milan Kocian
- Anästhesie und Intensiv, Asklepios Klinik, Burglengenfeld, Germany
- Visual Medicine s. r. o., Olomouc, Czech Republic
| | - Christian Kollmann
- Center for Medical Physics & Biomedical Engineering, Medical University Vienna, Austria
| | - Julian Künzel
- Otorhinolaryngology, University of Regensburg, Germany
| | - Adrian Lim
- Imaging, Imperial College, London, United Kingdom of Great Britain and Northern Ireland
| | - Giovanni Maconi
- Gastroenterology Unit, Department of Biomedical and Clinical Sciences, "L. Sacco" University Hospital, "L. Sacco" University Hospital, Milan, Italy
| | - Vladimir Mitkov
- Diagnostic Ultrasound Division, Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation
| | - Alina Popescu
- Gastroenterology, University of Medicine and Pharmacy, Timisoara, Romania
| | - Adrian Saftoiu
- Res Ctr Gastroenterol Hepatol, University of Medicine and Pharmacy of Craiova, Romania
| | - Paul S Sidhu
- Radiology, King's College London, United Kingdom of Great Britain and Northern Ireland
| | - Christian Jenssen
- Klinik für Innere Medizin, Krankenhaus Märkisch Oderland Strausberg/Wriezen, Germany
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8
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Pillong L, Bozzato A, Hecker D, Bozzato V, Schick B, Kulas P. “A Head Start or a Pain in the Neck?”—Establishment and Evaluation of a Video-Based “Hands-On” Head and Neck Ultrasound Course. Diagnostics (Basel) 2022; 12:diagnostics12051239. [PMID: 35626394 PMCID: PMC9141540 DOI: 10.3390/diagnostics12051239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has strongly highlighted the need for more digitalization in healthcare. Teaching ultrasound skills in online courses is a key challenge in this context. The aim of this study was to establish an online video-based head and neck ultrasound course with an evaluation of the quality, effectiveness, and feasibility of this teaching method compared to in-person teaching. Twenty-two medical students were taught head and neck ultrasound in two groups: one group in an in-person course and the other one in a video-based course. Learning success was analyzed using self-evaluation forms and external assessment by an experienced ultrasonographer. Comparing pre- and post-training self-evaluation, all participants showed statistically significant learning progress. In the external assessment, the overall scores in both groups did not differ significantly. The courses themselves were positively evaluated by all participants. Herein, we present the first feasibility study of a web-based head and neck-ultrasound course for medical students. The methodology provides the potential for future changes in telemedical education and sustainable improvements in telemedical teaching and global intra-clinical and interdisciplinary patient care.
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9
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Weimer JM, Rink M, Müller L, Arens C, Bozzato A, Künzel J. Sonografische Diagnostik im Kopf-Hals-Bereich – Teil 2: Transzervikale Sonografie. Laryngorhinootologie 2022; 101:156-175. [DOI: 10.1055/a-1667-8675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | | | | | | | - Julian Künzel
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Regensburg, Regensburg
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10
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ENT Residents Benefit from a Structured Operation Planning Approach in the Training of Functional Endoscopic Sinus Surgery. MEDICINA-LITHUANIA 2021; 57:medicina57101062. [PMID: 34684099 PMCID: PMC8541081 DOI: 10.3390/medicina57101062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/22/2021] [Accepted: 10/02/2021] [Indexed: 01/11/2023]
Abstract
Background and Objectives: Preoperative planning utilizing computed tomographies (CT) is of utmost importance in functional endoscopic sinus surgery (FESS). Frequently, no uniform documentation and planning structures are available to residents in training. Consequently, overall completeness and quality of operation planning may vary greatly. The objective of the present study was to evaluate the impact of a structured operation planning (SOP) approach on the report quality and user convenience during a 4-day sinus surgery course. Materials and Methods: Fifteen participant were requested to plan a FESS procedure based on a CT scan of the paranasal sinuses that exhibited common pathological features, in a conventional manner, using a free text. Afterwards, the participants reevaluated the same scans by means of a specifically designed structured reporting template. Two experienced ENT surgeons assessed the collected conventional operation planning (COP) and SOP methods independently with regard to time requirements, overall quality, and legibility. User convenience data were collected by utilizing visual analogue scales. Results: A significantly greater time expenditure was associated with SOPs (183 s vs. 297 s, p = 0.0003). Yet, legibility (100% vs. 72%, p < 0.0001) and overall completeness (61.3% vs. 22.7%, p < 0.0001) of SOPs was significantly superior to COPs. Additionally, description of highly relevant variants in anatomy and pathologies were outlined in greater detail. User convenience data delineated a significant preference for SOPs (VAS 7.9 vs. 6.9, p = 0.0185). Conclusions: CT-based planning of FESS procedures by residents in training using a structured approach is more time-consuming while producing a superior report quality in terms of detailedness and readability. Consequently, SOP can be considered as a valuable tool in the process of preoperative evaluations, especially within residency.
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11
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Dick H, Doth S, Ernst C, Fischer S, Holderried M. [Current developments on digitalization : Analysis of quality and economics in healthcare]. Urologe A 2021; 60:1141-1149. [PMID: 34347134 PMCID: PMC8335973 DOI: 10.1007/s00120-021-01606-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 11/29/2022]
Abstract
Hintergrund Im deutschen Gesundheitssystem und damit auch im Fachgebiet der Urologie gewinnen ökonomische Rahmenbedingungen zunehmend an Bedeutung und parallel dazu werden digitale Anwendungen vermehrt eingesetzt. Fragestellung Die Fragestellung betrifft die gesundheitsökonomische Auseinandersetzung mit den Rahmenbedingungen der Digitalisierung im deutschen Gesundheitssystem sowie ausgewählter Anwendungsbereiche in der Urologie. Material und Methoden Das Gutachten des Sachverständigenrates zur Begutachtung der Entwicklung im Gesundheitswesen (SVR) wird analysiert und eine systematische Literaturanalyse zum Einsatz der strukturierten Befundung und Analyse ausgewählter Literatur zu telemedizinischen Anwendungen in der Urologie unter gesundheitsökonomischen Gesichtspunkten durchgeführt. Ergebnisse Als zentrale Hemmnisse bei der Digitalisierung des deutschen Gesundheitswesens identifiziert der SVR dessen Regulierung und Komplexität sowie den Umgang mit Datenschutz und -sicherheit. Der Einsatz strukturierter Befundung kann Qualität, Effektivität und Effizienz der Befundung in der Urologie steigern. Im Hinblick auf die Kosten können signifikante Einsparungen mit zunehmender Digitalisierung in der Medizin realisiert werden. Schlussfolgerungen Aus medizinischer und gesundheitsökonomischer Perspektive besteht bei der Ausgestaltung von Rahmenbedingungen für digitale Anwendungen im deutschen Gesundheitssystem hinsichtlich der Informationssicherheit und des Datenschutzes weiterer Gestaltungsbedarf. Bei zielgerichtetem Einsatz von digitalen Anwendungen wie der strukturierten Befundung und der Telemedizin können optimale Voraussetzungen für den zunehmenden Einsatz von künstlicher Intelligenz im Fachgebiet der Urologie geschaffen werden.
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Affiliation(s)
- H Dick
- Institut Health Care & Public Management, Lehrstuhl für Ökonomik und Management sozialer Dienstleistungen (530B), Universität Hohenheim, Fruwirthstraße 48, 70599, Stuttgart, Deutschland
| | - S Doth
- Institut Health Care & Public Management, Lehrstuhl für Ökonomik und Management sozialer Dienstleistungen (530B), Universität Hohenheim, Fruwirthstraße 48, 70599, Stuttgart, Deutschland
| | - C Ernst
- Institut Health Care & Public Management, Lehrstuhl für Ökonomik und Management sozialer Dienstleistungen (530B), Universität Hohenheim, Fruwirthstraße 48, 70599, Stuttgart, Deutschland.
| | - S Fischer
- Institut Health Care & Public Management, Lehrstuhl für Ökonomik und Management sozialer Dienstleistungen (530B), Universität Hohenheim, Fruwirthstraße 48, 70599, Stuttgart, Deutschland
| | - M Holderried
- Institut Health Care & Public Management, Lehrstuhl für Ökonomik und Management sozialer Dienstleistungen (530B), Universität Hohenheim, Fruwirthstraße 48, 70599, Stuttgart, Deutschland.,Zentralbereich Medizin: Struktur‑, Prozess- und Qualitätsmanagement, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 6, 72076, Tübingen, Deutschland
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Structured Reporting of Computed Tomography Examinations in Post-Lung Transplantation Patients. J Comput Assist Tomogr 2021; 45:959-963. [PMID: 34347712 DOI: 10.1097/rct.0000000000001209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the benefits and potential of structured reports (SR) for chest computed tomography after lung transplantation. METHODS Free-text reports (FTR) and SR were generated for 49 computed tomography scans. Clinical routine reports were used as FTR. Two pulmonologists rated formal aspects, completeness, clinical utility, and overall quality. Wilcoxon and McNemar tests were used for statistical analysis. RESULTS Structured reports received significantly higher ratings for all formals aspects (P < 0.001, respectively). Completeness was higher in SR with regard to evaluation of bronchiectases, bronchial anastomoses, bronchiolitic and fibrotic changes (P < 0.001, respectively), and air trapping (P = 0.012), but not signs of pneumonia (P = 0.5). Clinical utility and overall quality were rated significantly higher for SR than FTR (P < 0.001, respectively). However, report type did not influence initiation of further diagnostic or therapeutic measures (P = 0.307 and 1.0). CONCLUSIONS Structured reports are superior to FTR with regard to formal aspects, completeness, clinical utility, and overall satisfaction of referring pulmonologists.
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Barbisan CC, Andres MP, Torres LR, Libânio BB, Torres US, D'Ippolito G, Racy DJ, Abrao MS. Structured MRI reporting increases completeness of radiological reports and requesting physicians' satisfaction in the diagnostic workup for pelvic endometriosis. Abdom Radiol (NY) 2021; 46:3342-3353. [PMID: 33625575 DOI: 10.1007/s00261-021-02966-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/13/2021] [Accepted: 01/16/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE MRI plays an important role in the diagnosis and surgical planning of pelvic endometriosis (PE), and imaging reports should contain all relevant information (completeness). As structured reports are being increasingly utilized, we aimed to evaluate whether structured MRI reporting increases the quality of reports regarding completeness and, consequently, their perceived value by gynecologists, in comparison to free-text reports. We also aimed to compare the diagnostic performance of both formats. METHODS We retrospectively included 28 consecutive women with histologically proven PE who underwent MRI within one month before surgery. Two abdominal radiologists (Rd1/Rd2, 3y/12y experience), blinded to clinical and surgical data, individually elaborated free-text reports and, four months later, structured reports. Completeness (defined as description of six key anatomical sites deemed essential for surgical planning in a consensus of four-blinded external experts) and diagnostic performance (sensitivity and specificity) by site (histology as reference) were compared between reports using the McNemar test. The satisfaction of gynecologists was compared using the marginal homogeneity test. RESULTS Structured reporting increased completeness for both Rd1 (rectosigmoid, retrocervical/uterosacral ligament, vagina, and ureter) and Rd2 (vagina, ureter, and bladder) (p < 0.05), without compromising sensitivity or specificity at any of the evaluated sites. Gynecologists' satisfaction was superior with structured reports in most comparisons. CONCLUSION Structured MRI reports perform better in fully documenting essential features of PE and are similar in terms of diagnostic performance, therefore having higher potential for surgical planning. Gynecologists found them easier to assess and were more satisfied with the information provided by structured reports.
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Affiliation(s)
| | - Marina Paula Andres
- BP- A Beneficência Portuguesa de São Paulo, São Paulo, Brazil
- Disciplina de Ginecologia, Departamento de Obstetrícia E Ginecologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Rua São Sebastião, 550, São Paulo, SP, 04708-001, Brazil
| | - Lucas R Torres
- BP- A Beneficência Portuguesa de São Paulo, São Paulo, Brazil
- Grupo Fleury, São Paulo, Brazil
| | - Bruna B Libânio
- BP- A Beneficência Portuguesa de São Paulo, São Paulo, Brazil
| | - Ulysses S Torres
- Grupo Fleury, São Paulo, Brazil
- Universidade Federal de São Paulo, São Paulo, Brazil
| | - Giuseppe D'Ippolito
- Grupo Fleury, São Paulo, Brazil
- Universidade Federal de São Paulo, São Paulo, Brazil
| | - Douglas J Racy
- BP- A Beneficência Portuguesa de São Paulo, São Paulo, Brazil
| | - Mauricio Simões Abrao
- BP- A Beneficência Portuguesa de São Paulo, São Paulo, Brazil.
- Disciplina de Ginecologia, Departamento de Obstetrícia E Ginecologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Rua São Sebastião, 550, São Paulo, SP, 04708-001, Brazil.
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Schnitzer ML, Sabel L, Schwarze V, Marschner C, Froelich MF, Nuhn P, Falck Y, Nuhn MM, Afat S, Staehler M, Rückel J, Clevert DA, Rübenthaler J, Geyer T. Structured Reporting in the Characterization of Renal Cysts by Contrast-Enhanced Ultrasound (CEUS) Using the Bosniak Classification System-Improvement of Report Quality and Interdisciplinary Communication. Diagnostics (Basel) 2021; 11:diagnostics11020313. [PMID: 33671991 PMCID: PMC7919270 DOI: 10.3390/diagnostics11020313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/29/2021] [Accepted: 02/11/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND This study aims to evaluate the potential benefits of structured reporting (SR) compared to conventional free-text reporting (FTR) in contrast-enhanced ultrasound (CEUS) of cystic renal lesions, based on the Bosniak classification. METHODS Fifty patients with cystic renal lesions who underwent CEUS were included in this single-center study. FTR created in clinical routine were compared to SR retrospectively generated by using a structured reporting template. Two experienced urologists evaluated the reports regarding integrity, effort for information extraction, linguistic quality, and overall quality. RESULTS The required information could easily be extracted by the reviewers in 100% of SR vs. 82% of FTR (p < 0.001). The reviewers trusted the information given by SR significantly more with a mean of 5.99 vs. 5.52 for FTR (p < 0.001). SR significantly improved the linguistic quality (6.0 for SR vs. 5.68 for FTR (p < 0.001)) and the overall report quality (5.98 for SR vs. 5.58 for FTR (p < 0.001)). CONCLUSIONS SR significantly increases the quality of radiologic reports in CEUS examinations of cystic renal lesions compared to conventional FTR and represents a promising approach to facilitate interdisciplinary communication in the future.
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Affiliation(s)
- Moritz L. Schnitzer
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (M.L.S.); (L.S.); (V.S.); (C.M.); (Y.F.); (M.-M.N.); (J.R.); (D.-A.C.); (J.R.)
| | - Laura Sabel
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (M.L.S.); (L.S.); (V.S.); (C.M.); (Y.F.); (M.-M.N.); (J.R.); (D.-A.C.); (J.R.)
| | - Vincent Schwarze
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (M.L.S.); (L.S.); (V.S.); (C.M.); (Y.F.); (M.-M.N.); (J.R.); (D.-A.C.); (J.R.)
| | - Constantin Marschner
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (M.L.S.); (L.S.); (V.S.); (C.M.); (Y.F.); (M.-M.N.); (J.R.); (D.-A.C.); (J.R.)
| | - Matthias F. Froelich
- Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany;
| | - Philipp Nuhn
- Department of Urology, University Medical Centre Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany;
| | - Yannick Falck
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (M.L.S.); (L.S.); (V.S.); (C.M.); (Y.F.); (M.-M.N.); (J.R.); (D.-A.C.); (J.R.)
| | - Maria-Magdalena Nuhn
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (M.L.S.); (L.S.); (V.S.); (C.M.); (Y.F.); (M.-M.N.); (J.R.); (D.-A.C.); (J.R.)
| | - Saif Afat
- Department for Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany;
| | - Michael Staehler
- Department of Urology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany;
| | - Johannes Rückel
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (M.L.S.); (L.S.); (V.S.); (C.M.); (Y.F.); (M.-M.N.); (J.R.); (D.-A.C.); (J.R.)
| | - Dirk-André Clevert
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (M.L.S.); (L.S.); (V.S.); (C.M.); (Y.F.); (M.-M.N.); (J.R.); (D.-A.C.); (J.R.)
| | - Johannes Rübenthaler
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (M.L.S.); (L.S.); (V.S.); (C.M.); (Y.F.); (M.-M.N.); (J.R.); (D.-A.C.); (J.R.)
| | - Thomas Geyer
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany; (M.L.S.); (L.S.); (V.S.); (C.M.); (Y.F.); (M.-M.N.); (J.R.); (D.-A.C.); (J.R.)
- Correspondence: ; Tel.: +49-89440073620
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Geyer T, Rübenthaler J, Marschner C, von Hake M, Fabritius MP, Froelich MF, Huber T, Nörenberg D, Rückel J, Weniger M, Martens C, Sabel L, Clevert DA, Schwarze V. Structured Reporting Using CEUS LI-RADS for the Diagnosis of Hepatocellular Carcinoma (HCC)-Impact and Advantages on Report Integrity, Quality and Interdisciplinary Communication. Cancers (Basel) 2021; 13:cancers13030534. [PMID: 33572502 PMCID: PMC7866827 DOI: 10.3390/cancers13030534] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 01/28/2021] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Contrast-enhanced ultrasound (CEUS) is an increasingly accepted imaging modality for visualizing hepatocellular carcinoma (HCC) and is recommended as a secondary imaging option by most leading hepatology societies. In recent years, the use of structured reporting (SR) has been recommended by several societies to standardize report content and improve report quality of various diagnostic modalities when compared to conventional free-text reports (FTR). Our single-center study aimed to evaluate the use of SR using a CEUS LI-RADS software template in CEUS examinations of 50 HCC patients. SR significantly increased report integrity, satisfaction of the referring physicians, linguistic quality and overall report quality compared to FTR. Therefore, the use of SR in CEUS examinations of HCC patients may represent a valuable tool to facilitate clinical decision-making and improve interdisciplinary communication in the future. Abstract Background: Our retrospective single-center study aims to evaluate the impact of structured reporting (SR) using a CEUS LI-RADS template on report quality compared to conventional free-text reporting (FTR) in contrast-enhanced ultrasound (CEUS) for the diagnosis of hepatocellular carcinoma (HCC). Methods: We included 50 patients who underwent CEUS for HCC staging. FTR created after these examinations were compared to SR retrospectively generated by using template-based online software with clickable decision trees. The reports were evaluated regarding report completeness, information extraction, linguistic quality and overall report quality by two readers specialized in internal medicine and visceral surgery. Results: SR significantly increased report completeness with at least one key feature missing in 31% of FTR vs. 2% of SR (p < 0.001). Information extraction was considered easy in 98% of SR vs. 86% of FTR (p = 0.004). The trust of referring physicians in the report was significantly increased by SR with a mean of 5.68 for SR vs. 4.96 for FTR (p < 0.001). SR received significantly higher ratings regarding linguistic quality (5.79 for SR vs. 4.83 for FTR (p < 0.001)) and overall report quality (5.75 for SR vs. 5.01 for FTR (p < 0.001)). Conclusions: Using SR instead of conventional FTR increases the overall quality of reports in CEUS examinations of HCC patients and may represent a valuable tool to facilitate clinical decision-making and improve interdisciplinary communication in the future.
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Affiliation(s)
- Thomas Geyer
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (J.R.); (C.M.); (M.v.H.); (M.P.F.); (J.R.); (L.S.); (D.-A.C.); (V.S.)
- Correspondence: ; Tel.: +49-894-4007-3620
| | - Johannes Rübenthaler
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (J.R.); (C.M.); (M.v.H.); (M.P.F.); (J.R.); (L.S.); (D.-A.C.); (V.S.)
| | - Constantin Marschner
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (J.R.); (C.M.); (M.v.H.); (M.P.F.); (J.R.); (L.S.); (D.-A.C.); (V.S.)
| | - Malte von Hake
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (J.R.); (C.M.); (M.v.H.); (M.P.F.); (J.R.); (L.S.); (D.-A.C.); (V.S.)
| | - Matthias P. Fabritius
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (J.R.); (C.M.); (M.v.H.); (M.P.F.); (J.R.); (L.S.); (D.-A.C.); (V.S.)
| | - Matthias F. Froelich
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, 68167 Mannheim, Germany; (M.F.F.); (T.H.); (D.N.)
| | - Thomas Huber
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, 68167 Mannheim, Germany; (M.F.F.); (T.H.); (D.N.)
| | - Dominik Nörenberg
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, 68167 Mannheim, Germany; (M.F.F.); (T.H.); (D.N.)
| | - Johannes Rückel
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (J.R.); (C.M.); (M.v.H.); (M.P.F.); (J.R.); (L.S.); (D.-A.C.); (V.S.)
| | - Maximilian Weniger
- Department of General, Visceral, and Transplantation Surgery, University Hospital, LMU Munich, 81377 Munich, Germany;
| | - Corinna Martens
- Department of Medicine II, University Hospital, LMU Munich, 81377 Munich, Germany;
| | - Laura Sabel
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (J.R.); (C.M.); (M.v.H.); (M.P.F.); (J.R.); (L.S.); (D.-A.C.); (V.S.)
| | - Dirk-André Clevert
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (J.R.); (C.M.); (M.v.H.); (M.P.F.); (J.R.); (L.S.); (D.-A.C.); (V.S.)
| | - Vincent Schwarze
- Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany; (J.R.); (C.M.); (M.v.H.); (M.P.F.); (J.R.); (L.S.); (D.-A.C.); (V.S.)
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[Quality in the appraisal of head and neck sonography results in university hospitals-a random sample]. HNO 2021; 69:907-912. [PMID: 33439274 PMCID: PMC8545731 DOI: 10.1007/s00106-020-00989-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2020] [Indexed: 02/07/2023]
Abstract
Hintergrund Die Ultraschalldiagnostik gilt für den Radiologen, Hals-Nasen-Ohren-Arzt (HNO) oder Mund-Kiefer-Gesichts-Chirurgen als Standard in der Abklärung zahlreicher Pathologien. Es besteht ein Konsens, dass die digitale Dokumentation heute dringend notwendig ist, um die Qualität der sonographischen Dokumentationen zu verbessern und zu standardisieren. Es häufen sich Publikationen zur Implementierung standardisierter Befunddokumentation einschließlich der Kopf- und Halssonographie. Ziel der Arbeit Die vorliegende Arbeit zielt darauf ab, die Qualität von routinemäßig angefertigten Kopf- und Halssonographiebefunden nach Kriterien der Kassenärztlichen Vereinigung (KV) Bayern an einer Auswahl deutscher HNO-Universitätskliniken stichprobenartig zu ermitteln. Material und Methoden Insgesamt wurden retrospektiv 70 zufällig ausgewählte, anonymisierte schriftliche Befunde einschließlich Bildmaterial von insgesamt 7 HNO-Universitätskliniken stichprobenartig nach KV-Kriterien durch einen erfahrenen Prüfer der KV Bayern ausgewertet und deskriptiv analysiert. Ergebnisse Von 70 Befunden konnten 69 ausgewertet werden. Die Dokumentationsvollständigkeit lag im Mittel bei 80,6 %. Neun Befunde waren vollständig korrekt dokumentiert (13 %). Die Dokumentationsvollständigkeit der einzelnen Kliniken lag zwischen 68,1 % und 93 %. Mit 88,5 % vs. 75 % erbrachte eine strukturierte Befundung eine höhere Befundvollständigkeit. In 75 % der Fälle verfügten die Kliniken mit strukturiertem Befund auch über digitale Dokumentationslösungen. Schlussfolgerung Die Vollständigkeit und Qualität von routinemäßig angefertigten Kopf- und Halssonographiebefunden an einer Auswahl von HNO-Universitätskliniken ist insgesamt optimierbar. Die Implementierung strukturierter Befundmasken und die Umstellung der analogen Dokumentation auf digitale Lösungen sowie Vernetzung mit dem Klinikinformationssystem (KIS) und Bildarchivierungs- und Kommunikationssystem (PACS) sollte weiter vorangetrieben werden. Darüber hinaus sind leitende Ärzte dazu angehalten, die Befundqualität unerfahrener Kollegen regelmäßig zu prüfen und im Rahmen der Facharztausbildung auf die Erfüllung entsprechender Standards wie der KV-Ultraschallvereinbarung hinzuarbeiten.
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Ernst BP, Reissig MR, Strieth S, Eckrich J, Hagemann JH, Döge J, Matthias C, Gouveris H, Rübenthaler J, Weiss R, Sommer WH, Nörenberg D, Huber T, Gonser P, Becker S, Froelich MF. The role of structured reporting and structured operation planning in functional endoscopic sinus surgery. PLoS One 2020; 15:e0242804. [PMID: 33253265 PMCID: PMC7703956 DOI: 10.1371/journal.pone.0242804] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/09/2020] [Indexed: 12/22/2022] Open
Abstract
Computed tomography (CT) scans represent the gold standard in the planning of functional endoscopic sinus surgeries (FESS). Yet, radiologists and otolaryngologists have different perspectives on these scans. In general, residents often struggle with aspects involved in both reporting and operation planning. The aim of this study was to compare the completeness of structured reports (SR) of preoperative CT images and structured operation planning (SOP) to conventional reports (CR) and conventional operation planning (COP) to potentially improve future treatment decisions on an individual level. In total, 30 preoperative CT scans obtained for surgical planning of patients scheduled for FESS were evaluated using SR and CR by radiology residents. Subsequently, otolaryngology residents performed a COP using free texts and a SOP using a specific template. All radiology reports and operation plannings were evaluated by two experienced FESS surgeons regarding their completeness for surgical planning. User satisfaction of otolaryngology residents was assessed by using visual analogue scales. Overall radiology report completeness was significantly higher using SRs regarding surgically important structures compared to CRs (84.4 vs. 22.0%, p<0.001). SOPs produced significantly higher completeness ratings (97% vs. 39.4%, p<0.001) regarding pathologies and anatomical variances. Moreover, time efficiency was not significantly impaired by implementation of SR (148 s vs. 160 s, p = 0.61) and user satisfaction was significantly higher for SOP (VAS 8.1 vs. 4.1, p<0.001). Implementation of SR and SOP results in a significantly increased completeness of radiology reports and operation planning for FESS. Consequently, the combination of both facilitates surgical planning and may decrease potential risks during FESS.
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Affiliation(s)
- Benjamin Philipp Ernst
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Rhineland-Palatinate, Germany
- * E-mail:
| | - Manuel René Reissig
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Rhineland-Palatinate, Germany
| | - Sebastian Strieth
- Department of Otorhinolaryngology, University Hospital Bonn, Bonn, North Rhine-Westphalia, Germany
| | - Jonas Eckrich
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Rhineland-Palatinate, Germany
| | - Jan H. Hagemann
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Rhineland-Palatinate, Germany
| | - Julia Döge
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Rhineland-Palatinate, Germany
| | - Christoph Matthias
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Rhineland-Palatinate, Germany
| | - Haralampos Gouveris
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Rhineland-Palatinate, Germany
| | | | - Roxanne Weiss
- Department of Otorhinolaryngology, University Hospital Frankfurt, Frankfurt, Hessen, Germany
| | - Wieland H. Sommer
- Department of Radiology, LMU University Hospital, Munich, Bavaria, Germany
| | - Dominik Nörenberg
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Baden-Wuerttemberg, Germany
| | - Thomas Huber
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Baden-Wuerttemberg, Germany
| | - Phillipp Gonser
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Tübingen Medical Center, Tübingen, Baden-Wuerttemberg, Germany
| | - Sven Becker
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Tübingen Medical Center, Tübingen, Baden-Wuerttemberg, Germany
| | - Matthias F. Froelich
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Baden-Wuerttemberg, Germany
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The use of structured reporting of head and neck ultrasound ensures time-efficiency and report quality during residency. Eur Arch Otorhinolaryngol 2019; 277:269-276. [PMID: 31612337 DOI: 10.1007/s00405-019-05679-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 10/01/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Free text reports (FTR) of head and neck ultrasound studies are currently deployed in most departments. Because of a lack of composition and language, these reports vary greatly in terms of quality and reliability. This may impair the learning process during residency. The purpose of the study was to analyze the longitudinal effects of using structured reports (SR) of head and neck ultrasound studies during residency. METHODS Attending residents (n = 24) of a tripartite course on head and neck ultrasound, accredited by the German Society for Ultrasound in Medicine (DEGUM), were randomly allocated to pictures of common diseases. Both SRs and FTRs were compiled. All reports were analyzed concerning completeness, acquired time and legibility. Overall user contentment was evaluated by a questionnaire. RESULTS SRs achieved significantly higher ratings regarding completeness (95.6% vs. 26.4%, p < 0.001), description of pathologies (72.2% vs. 58.9%, p < 0.001) and legibility (100% vs. 52.4%, p < 0.001) with a very high inter-rater reliability (Fleiss' kappa 0.9). Reports were finalized significantly faster (99.1 s vs. 115.0 s, p < 0.001) and user contentment was significantly better when using SRs (8.3 vs. 6.3, p < 0.001). In particular, only SRs showed a longitudinally increasing time efficiency (- 20.1 s, p = 0.036) while maintaining consistent completeness ratings. CONCLUSIONS The use of SRs of head and neck ultrasound studies results in an increased longitudinal time-efficiency while upholding the report quality at the same time. This may indicate an additive learning effect of structured reporting. Superior outcomes in terms of comprehensiveness, legibility and time-efficiency can be observed immediately after implementation.
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