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Mañas-García A, González-Valverde I, Camacho-Ramos E, Alberich-Bayarri A, Maldonado JA, Marcos M, Robles M. Radiological Structured Report Integrated with Quantitative Imaging Biomarkers and Qualitative Scoring Systems. J Digit Imaging 2022; 35:396-407. [PMID: 35106674 PMCID: PMC9156634 DOI: 10.1007/s10278-022-00589-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 01/15/2022] [Accepted: 01/18/2022] [Indexed: 12/15/2022] Open
Abstract
The benefits of structured reporting (SR) in radiology are well-known and have been widely described. However, there are limitations that must be overcome. Radiologists may be reluctant to change the conventional way of reporting. Error rates could potentially increase if SR is used improperly. Interruption of the visual search pattern by keeping the eyes focused on the report rather than the images may increase reporting time. Templates that include unnecessary or irrelevant information may undermine the consistency of the report. Last, the lack of support for multiple languages may hamper the adaptation of the report to the target audience. This work aims to mitigate these limitations with a web-based structured reporting system based on templates. By including field validators and logical rules, the system avoids reporting mistakes and allows to automatically calculate values and radiological qualitative scores. The system can manage quantitative information from imaging biomarkers, combining this with qualitative radiological information usually present in the structured report. It manages SR templates as plugins (IHE MRRT compliant and compatible with RSNA's Radreport templates), ensures a seamless integration with PACS/RIS systems, and adapts the report to the target audience by means of natural language extracts generated in multiple languages. We describe a use case of SR template for prostate cancer including PI-RADS 2.1 scoring system and imaging biomarkers. For the time being, the system comprises 24 SR templates and provides service in 37 hospitals and healthcare institutions, endorsing the success of this contribution to mitigate some of the limitations of the SR.
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Affiliation(s)
- A. Mañas-García
- grid.157927.f0000 0004 1770 5832Dept. Computer and Communication Systems and Health Technology Economics, Universitat Politècnica de València, Valencia, Spain ,Quantitative Imaging Biomarkers in Medicine (Quibim), Valencia, Spain
| | | | - E. Camacho-Ramos
- Quantitative Imaging Biomarkers in Medicine (Quibim), Valencia, Spain
| | | | | | - M. Marcos
- grid.9612.c0000 0001 1957 9153Department of Computer Engineering and Science, Universitat Jaume I, Castellón, Spain
| | - M. Robles
- grid.157927.f0000 0004 1770 5832Dept. Computer and Communication Systems and Health Technology Economics, Universitat Politècnica de València, Valencia, Spain
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Lee JK, Bermel R, Bullen J, Ruggieri P, Jones SE. Structured Reporting in Multiple Sclerosis Reduces Interpretation Time. Acad Radiol 2021; 28:1733-1738. [PMID: 32868172 DOI: 10.1016/j.acra.2020.08.006] [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: 06/02/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 02/01/2023]
Abstract
RATIONALE AND OBJECTIVES Previous studies have reported mixed results regarding whether the use of structured reporting (SR) leads to a change in interpretation times. The objective of this study was to quantify any change in interpretation times after the implementation of SR for multiple sclerosis (MS) follow-up magnetic resonance imaging (MRI) of the brain. MATERIALS AND METHODS Interpretation times before and after the transition to MS MRI SR were compared over a 5-year period. To control for changing practice patterns, a control group of non-MS (intracranial masses) reports not using SR was also assessed. In a secondary analysis, interpretation times for 2D and 3D MRI MS protocols after the initiation of SR were compared to determine whether increased image number with the 3D protocol affected interpretation times. RESULTS Mean and median interpretation times before the initiation of SR for MS MRI were 11.0 and 8.0 minutes versus 8.5 and 6.0 minutes after the implementation of SR (p < 0.001). Although non-MS MRI interpretation times also decreased, an interaction analysis demonstrated that the decrease in MS interpretation times was significantly higher (p < 0.001). Mean and median interpretation times using 3D protocols were slighter increased compared to interpretation times with 2D protocols (p = 0.036). CONCLUSION After the implementation of SR for MS follow-up MRI at our institution, interpretation times significantly decreased despite the increased number of images with some of the examinations due to the adoption of 3D protocols. The adoption of SR for MS MRI follow-up scans may improve radiologist efficiency.
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Affiliation(s)
- Jonathan K Lee
- Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195.
| | - Robert Bermel
- Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jennifer Bullen
- Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195
| | - Paul Ruggieri
- Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195
| | - Stephen E Jones
- Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195
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Kim SH, Sobez LM, Spiro JE, Curta A, Ceelen F, Kampmann E, Goepfert M, Bodensohn R, Meinel FG, Sommer WH, Sommer NN, Galiè F. Structured reporting has the potential to reduce reporting times of dual-energy x-ray absorptiometry exams. BMC Musculoskelet Disord 2020; 21:248. [PMID: 32299400 PMCID: PMC7164197 DOI: 10.1186/s12891-020-03200-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 03/10/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND In recent years, structured reporting has been shown to be beneficial with regard to report completeness and clinical decision-making as compared to free-text reports (FTR). However, the impact of structured reporting on reporting efficiency has not been thoroughly evaluted yet. The aim of this study was to compare reporting times and report quality of structured reports (SR) to conventional free-text reports of dual-energy x-ray absorptiometry exams (DXA). METHODS FTRs and SRs of DXA were retrospectively generated by 2 radiology residents and 2 final-year medical students. Time was measured from the first view of the exam until the report was saved. A random sample of DXA reports was selected and sent to 2 referring physicians for further evaluation of report quality. RESULTS A total of 104 DXA reports (both FTRs and SRs) were generated and 48 randomly selected reports were evaluated by referring physicians. Reporting times were shorter for SRs in both radiology residents and medical students with median reporting times of 2.7 min (residents: 2.7, medical students: 2.7) for SRs and 6.1 min (residents: 5.0, medical students: 7.5) for FTRs. Information extraction was perceived to be significantly easier from SRs vs FTRs (P < 0.001). SRs were rated to answer the clinical question significantly better than FTRs (P < 0.007). Overall report quality was rated significantly higher for SRs compared to FTRs (P < 0.001) with 96% of SRs vs 79% of FTRs receiving high or very high-quality ratings. All readers except for one resident preferred structured reporting over free-text reporting and both referring clinicians preferred SRs over FTRs for DXA. CONCLUSIONS Template-based structured reporting of DXA might lead to shorter reporting times and increased report quality.
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Affiliation(s)
- Su Hwan Kim
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Lara M Sobez
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Judith E Spiro
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Adrian Curta
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Felix Ceelen
- Munich Transplant Center, University Hospital, LMU Munich, Munich, Germany
| | - Eric Kampmann
- Department of Internal Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Martin Goepfert
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Raphael Bodensohn
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Felix G Meinel
- Department of Diagnostic and Interventional Radiology, Paediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany
| | - Wieland H Sommer
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Nora N Sommer
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Franziska Galiè
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany.
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Evidence of the benefits, advantages and potentialities of the structured radiological report: An integrative review. Artif Intell Med 2019; 102:101770. [PMID: 31980107 DOI: 10.1016/j.artmed.2019.101770] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 11/21/2019] [Accepted: 11/24/2019] [Indexed: 12/27/2022]
Abstract
The structured report is a new trend for the preparation and manipulation of radiological examination reports. The structuring of the radiological report data can bring many benefits and advantages over other existing methodologies. Research and studies about the structured radiological report are highly relevant in clinical and academic subjects, improving medical practice, reducing unobserved problems by radiologists, improving reporting practices and medical diagnoses. Exposing the benefits, advantages and potential of the structured radiological report is important in encouraging the acceptance and implementation of this method by radiology professionals who are still somewhat resistant. The present review highlights the factors that contribute to the consolidation of adopting the structured radiology report methodology, addressing a variety of studies focused on the structuring of the radiological report. This integrative review of the literature is proposed by searching publications and journals databases (CAPES - Coordination of Improvement of Higher-Level Personnel, SciELO - Scientific Electronic Library Online, and PubMed - Publisher Medline) to develop a complete and unified understanding of the subject, so that it becomes a major part of evidence-based initiatives.
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Possible Bias From Prepopulated Impressions in Structured Radiology Reports. J Am Coll Radiol 2019; 16:724-727. [DOI: 10.1016/j.jacr.2018.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/31/2018] [Accepted: 11/09/2018] [Indexed: 11/23/2022]
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Shea LAG, Towbin AJ. The state of structured reporting: the nuance of standardized language. Pediatr Radiol 2019; 49:500-508. [PMID: 30923882 DOI: 10.1007/s00247-019-04345-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/04/2018] [Accepted: 01/11/2019] [Indexed: 12/26/2022]
Abstract
Radiology reports are the principal form of communication with the referring provider. Unfortunately, they can be a form of communication riddled with errors and inscrutable statements burying the intended meaning, failing to achieve the main task for which it was made: communicating key imaging findings as they pertain to the clinical question being posed. Structured reporting is a multifaceted and modular solution to problematic reports, with variable iterations and benefits. Structured reports have been adapted across departments and even national societies, with standardized format, content and language. Newer developments include contextual reporting and common data elements. Herein, we discuss the various forms and levels of structured reporting and the latest advancements, as well as the general acceptance within radiology. We also discuss some areas for improvement as the practice of structured reporting matures.
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Affiliation(s)
- Lindsey A G Shea
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Alexander J Towbin
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA. .,Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Buckley BW, Daly L, Allen GN, Ridge CA. Recall of structured radiology reports is significantly superior to that of unstructured reports. Br J Radiol 2018; 91:20170670. [PMID: 29189048 DOI: 10.1259/bjr.20170670] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To measure recall of structured compared with unstructured radiology reports. METHODS Institutional review board approval was obtained. Four hypothetical radiology reports, two structured and two unstructured reports, were created for the purposes of this study by an experienced consultant radiologist. The reports, each followed immediately by a multiple-choice questionnaire listing possible diagnoses from the report, were distributed to the members of two national physician associations using a web-based survey tool. Based on the number of correct responses, correct critical findings and incorrect responses, rates per number of potential diagnoses were calculated for each individual and averaged. The paired sign test compared results between structured and unstructured reports. RESULTS 148 respondents completed the survey, 126 (85.1%) of whom were physicians. The mean percentage of incorrect diagnoses was 4.5% for structured reports compared with 16.7% for unstructured reports (p < 0.001). The average rate of critical diagnosis recall was 82.7% for structured reports and 65.1% for unstructured reports (p < 0.001). The average percentage of all diagnoses detected for structured compared with unstructured reports was 64.3 and 59.0%, respectively (p = 0.007). CONCLUSION Recall of structured radiology reports is significantly superior to recall of unstructured reports immediately after reading the report. Advances in knowledge: A structured radiology report format can positively impact the referring clinician's ability to recall the critical findings with statistically significance.
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Affiliation(s)
| | - Leslie Daly
- 2 University College Dublin , Dublin , Ireland
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