1
|
Ge X, Zhang L, Liu M, Wang X, Xu X, Yan Y, Tian C, Yang J, Ding Y, Yu C, Lu J, Jiang L, Wang Q, Zhang Q, Song C. Association of Mosaic Chromosomal Alterations and Genetic Factors with the Risk of Cirrhosis. J Clin Transl Hepatol 2024; 12:562-570. [PMID: 38974956 PMCID: PMC11224905 DOI: 10.14218/jcth.2023.00575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/07/2024] [Accepted: 04/11/2024] [Indexed: 07/09/2024] Open
Abstract
Background and Aims Age-related mosaic chromosomal alterations (mCAs) detected from genotyping of blood-derived DNA are structural somatic variants that indicate clonal hematopoiesis. This study aimed to investigate whether mCAs contribute to the risk of cirrhosis and modify the effect of a polygenic risk score (PRS) on cirrhosis risk prediction. Methods mCA call sets of individuals with European ancestry were obtained from the UK Biobank. The PRS was constructed based on 12 susceptible single-nucleotide polymorphisms for cirrhosis. Cox proportional hazard models were applied to evaluate the associations between mCAs and cirrhosis risk. Results Among 448,645 individuals with a median follow-up of 12.5 years, we identified 2,681 cases of cirrhosis, 1,775 cases of compensated cirrhosis, and 1,706 cases of decompensated cirrhosis. Compared to non-carriers, individuals with copy-neutral loss of heterozygosity mCAs had a significantly increased risk of cirrhosis (hazard ratio (HR) 1.42, 95% confidence interval (CI) 1.12-1.81). This risk was higher in patients with expanded cell fractions of mCAs (cell fractions ≥10% vs. cell fractions <10%), especially for the risk of decompensated cirrhosis (HR 2.03 [95% CI 1.09-3.78] vs. 1.14 [0.80-1.64]). In comparison to non-carriers of mCAs with low genetic risk, individuals with expanded copy-neutral loss of heterozygosity and high genetic risk showed the highest cirrhosis risk (HR 5.39 [95% CI 2.41-12.07]). Conclusions The presence of mCAs is associated with increased susceptibility to cirrhosis risk and could be combined with PRS for personalized cirrhosis risk stratification.
Collapse
Affiliation(s)
- Xinyuan Ge
- Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lu Zhang
- Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Maojie Liu
- Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiao Wang
- Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
- The Dumont-UCLA Transplant Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Xin Xu
- Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuqian Yan
- Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chan Tian
- Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Juan Yang
- Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yang Ding
- Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chengxiao Yu
- Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Health Promotion Center, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
| | - Jing Lu
- Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Health Promotion Center, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
| | - Longfeng Jiang
- Department of Infectious Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qiang Wang
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Qun Zhang
- Department of Health Promotion Center, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
| | - Ci Song
- Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Health Promotion Center, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
- Changzhou Medical Center, Nanjing Medical University, Nanjing, Jiangsu, China
- Research Units of Cohort Study on Cardiovascular Diseases and Cancers, Chinese Academy of Medical Sciences, Beijing, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| |
Collapse
|
2
|
Digby GC, Lam S, Tammemägi MC, Finley C, Dennie C, Snow S, Habert J, Taylor J, Gonzalez AV, Spicer J, Sahota J, Guy D, Marino P, Manos D. Recommendations to Improve Management of Incidental Pulmonary Nodules in Canada: Expert Panel Consensus. Can Assoc Radiol J 2024:8465371241257910. [PMID: 38869196 DOI: 10.1177/08465371241257910] [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: 06/14/2024] Open
Abstract
Introduction: Incidental pulmonary nodules (IPN) are common radiologic findings, yet management of IPNs is inconsistent across Canada. This study aims to improve IPN management based on multidisciplinary expert consensus and provides recommendations to overcome patient and system-level barriers. Methods: A modified Delphi consensus technique was conducted. Multidisciplinary experts with extensive experience in lung nodule management in Canada were recruited to participate in the panel. A survey was administered in 3 rounds, using a 5-point Likert scale to determine the level of agreement (1 = extremely agree, 5 = extremely disagree). Results: Eleven experts agreed to participate in the panel; 10 completed all 3 rounds. Consensus was achieved for 183/217 (84.3%) statements. Panellists agreed that radiology reports should include a standardized summary of findings and follow-up recommendations for all nodule sizes (ie, <6, 6-8, and >8 mm). There was strong consensus regarding the importance of an automated system for patient follow-up and that leadership support for organizational change at the administrative level is of utmost importance in improving IPN management. There was no consensus on the need for standardized national referral pathways, development of new guidelines, or establishing a uniform picture archiving and communication system. Conclusion: Canadian IPN experts agree that improved IPN management should include standardized radiology reporting of IPNs, standardized and automated follow-up of patients with IPNs, guideline adherence and implementation, and leadership support for organizational change. Future research should focus on the implementation and long-term effectiveness of these recommendations in clinical practice.
Collapse
Affiliation(s)
- Geneviève C Digby
- Department of Medicine, Division of Respirology, Queen's University, Kingston, ON, Canada
| | - Stephen Lam
- Department of Integrative Oncology, BC Cancer and the University of British Columbia, Vancouver, BC, Canada
| | - Martin C Tammemägi
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Christian Finley
- Department of Surgery, Division of Thoracic Surgery, McMaster University, Hamilton, ON, Canada
| | - Carole Dennie
- Department of Radiology, Radiation Oncology and Medical Physics, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Stephanie Snow
- Department of Medicine, Division of Medical Oncology, Dalhousie University, Halifax, NS, Canada
| | - Jeffrey Habert
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Jana Taylor
- Department of Diagnostic Radiology, McGill University Health Centre, Montreal, QC, Canada
| | - Anne V Gonzalez
- Department of Medicine, Division of Respiratory Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Jonathan Spicer
- Department of Surgery, Division of Thoracic Surgery, McGill University, Montreal, QC, Canada
| | - Jyoti Sahota
- Health Economics and Market Access, Amaris Consulting, Toronto, ON, Canada
| | - Danielle Guy
- Health Economics and Market Access, Amaris Consulting, Barcelona, Spain
| | - Paola Marino
- Health Economics and Market Access, Amaris Consulting, Montreal, QC, Canada
| | - Daria Manos
- Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada
| |
Collapse
|
3
|
Glandorf J, Vogel-Claussen J. Incidental pulmonary nodules - current guidelines and management. ROFO-FORTSCHR RONTG 2024; 196:582-590. [PMID: 38065544 DOI: 10.1055/a-2185-8714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
BACKGROUND Due to the greater use of high-resolution cross-sectional imaging, the number of incidental pulmonary nodules detected each year is increasing. Although the vast majority of incidental pulmonary nodules are benign, many early lung carcinomas could be diagnosed with consistent follow-up. However, for a variety of reasons, the existing recommendations are often not implemented correctly. Therefore, potential for improvement with respect to competence, communication, structure, and process is described. METHODS This article presents the recommendations for incidental pulmonary nodules from the current S3 guideline for lung cancer (July 2023). The internationally established recommendations (BTS guidelines and Fleischner criteria) are compared and further studies on optimized management were included after a systematic literature search in PubMed. RESULTS AND CONCLUSION In particular, AI-based software solutions are promising, as they can be used in a support capacity on several levels at once and can lead to simpler and more automated management. However, to be applicable in routine clinical practice, software must fit well into the radiology workflow and be integrated. In addition, "Lung Nodule Management" programs or clinics that follow a high-quality procedure for patients with incidental lung nodules or nodules detected by screening have been established in the USA. Similar structures might also be implemented in Germany in a future screening program in which patients with incidental pulmonary nodules could be included. KEY POINTS · Incidental pulmonary nodules are common but are often not adequately managed. · The updated S3 guideline for lung cancer now includes recommendations for incidental pulmonary nodules. · Competence, communication, structure, and process levels offer significant potential for improvement. CITATION FORMAT · Glandorf J, Vogel-Claussen J, . Incidental pulmonary nodules - current guidelines and management. Fortschr Röntgenstr 2024; 196: 582 - 590.
Collapse
Affiliation(s)
- Julian Glandorf
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Jens Vogel-Claussen
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| |
Collapse
|
4
|
Watanabe A, Nabata K, Wiseman SM. Synoptic operative reporting in cancer surgery: A scoping review. Am J Surg 2023; 225:878-886. [PMID: 36635131 DOI: 10.1016/j.amjsurg.2023.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/13/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND Narrative operative reports (NOR) are important for cancer management but often lack key information. This review investigated the efficacy of synoptic operative reports (SORs) for cancer operations compared to NORs. METHODS A database search included published studies up to October 31, 2021. Overall report completeness and reporting frequencies of cancer elements were descriptively compared between NORs and SORs. RESULTS Among 4353 studies, 32 were included. 47% of studies compared NORs to SORs. Overall completeness favored SORs (80 ± 19%) over NORs (47 ± 18%, p < 0.001). Essential cancer operative report elements including tumor location (NOR: 51 ± 28%, SOR: 89 ± 11%, p < 0.001), presence of metastases (NOR: 36 ± 33%, SOR: 96 ± 5%, p < 0.001), and final resection margins (NOR: 39 ± 30%, SOR: 87 ± 17%, p < 0.001) demonstrated higher mean reporting frequencies in SORs. CONCLUSION Overall completeness and reporting of cancer elements were superior in SORs. Although standardization of SORs requires further research, transition from NORs to SORs may improve the quality of postoperative cancer care.
Collapse
Affiliation(s)
- Akie Watanabe
- Department of Surgery, St. Paul's Hospital & University of British Columbia, 1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada.
| | - Kylie Nabata
- Department of Surgery, St. Paul's Hospital & University of British Columbia, 1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada.
| | - Sam M Wiseman
- Department of Surgery, St. Paul's Hospital & University of British Columbia, 1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada.
| |
Collapse
|
5
|
Lee JC, Delaney FT. Prevalence and clinical significance of incidental findings on CT attenuation correction for myocardial perfusion imaging. J Nucl Cardiol 2022; 29:1813-1822. [PMID: 33754302 DOI: 10.1007/s12350-020-02499-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 12/07/2020] [Indexed: 10/21/2022]
Abstract
BACKGROUND The appropriate clinical approach to incidentally detected lesions (IDLs) on CT attenuation correction (CTAC) images in myocardial perfusion imaging (MPI) remains uncertain. We sought to establish their prevalence and clinical significance in a large cohort and compared to previous studies to help provide further clarity and guide future clinical practice. METHODS AND RESULTS A total of 3758 MPI studies were reviewed retrospectively. IDLs of potential clinical significance-not known before MPI - were reported in 245 (6.5%) of these cases. Following appropriate further investigation/follow-up, these were of proven clinical significance in 30 (12.2%) cases with 14 patients (5.7%) harboring previously undiagnosed or progressive malignancies. The positive predictive value (PPV) for clinically significant incidental findings on CTAC images was 17.2% and the PPV value for incidental malignant findings was 8.0%. CONCLUSION Although incidental findings on CTAC images in MPI are common and often clearly insignificant at time of MPI reporting, many are clinically significant with a relatively high positive predictive value. This is especially so for malignancies. Our findings, therefore, in combination with previous studies as described here support routine reporting and appropriate further investigation of incidental CTAC findings in MPI.
Collapse
Affiliation(s)
- Joseph C Lee
- Department of Medical Imaging, The Prince Charles Hospital, Brisbane, QLD, 4032, Australia.
- Faculty of Medicine, The University of Queensland, Herston, Australia.
| | - Francis T Delaney
- Radiology Department, Mater Misericordiae University Hospital, Dublin, Ireland
| |
Collapse
|
6
|
Nobel JM, van Geel K, Robben SGF. Structured reporting in radiology: a systematic review to explore its potential. Eur Radiol 2022; 32:2837-2854. [PMID: 34652520 PMCID: PMC8921035 DOI: 10.1007/s00330-021-08327-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/15/2021] [Accepted: 09/13/2021] [Indexed: 10/31/2022]
Abstract
OBJECTIVES Structured reporting (SR) in radiology reporting is suggested to be a promising tool in clinical practice. In order to implement such an emerging innovation, it is necessary to verify that radiology reporting can benefit from SR. Therefore, the purpose of this systematic review is to explore the level of evidence of structured reporting in radiology. Additionally, this review provides an overview on the current status of SR in radiology. METHODS A narrative systematic review was conducted, searching PubMed, Embase, and the Cochrane Library using the syntax 'radiol*' AND 'structur*' AND 'report*'. Structured reporting was divided in SR level 1, structured layout (use of templates and checklists), and SR level 2, structured content (a drop-down menu, point-and-click or clickable decision trees). Two reviewers screened the search results and included all quantitative experimental studies that discussed SR in radiology. A thematic analysis was performed to appraise the evidence level. RESULTS The search resulted in 63 relevant full text articles out of a total of 8561 articles. Thematic analysis resulted in 44 SR level 1 and 19 level 2 reports. Only one paper was scored as highest level of evidence, which concerned a double cohort study with randomized trial design. CONCLUSION The level of evidence for implementing SR in radiology is still low and outcomes should be interpreted with caution. KEY POINTS • Structured reporting is increasingly being used in radiology, especially in abdominal and neuroradiological CT and MRI reports. • SR can be subdivided into structured layout (SR level 1) and structured content (SR level 2), in which the first is defined as being a template in which the reporter has to report; the latter is an IT-based manner in which the content of the radiology report can be inserted and displayed into the report. • Despite the extensive amount of research on the subject of structured reporting, the level of evidence is low.
Collapse
Affiliation(s)
- J Martijn Nobel
- Department of Radiology, Maastricht University Medical Center+, Postbox 5800, 6202 AZ, Maastricht, the Netherlands.
- Department of Educational Development and Research and School of Health Professions Education, Maastricht University, Maastricht, the Netherlands.
| | - Koos van Geel
- Department of Educational Development and Research and School of Health Professions Education, Maastricht University, Maastricht, the Netherlands
- Department of Medical Imaging of Zuyderland Medical Center, Heerlen, the Netherlands
| | - Simon G F Robben
- Department of Radiology, Maastricht University Medical Center+, Postbox 5800, 6202 AZ, Maastricht, the Netherlands
- Department of Educational Development and Research and School of Health Professions Education, Maastricht University, Maastricht, the Netherlands
| |
Collapse
|
7
|
Melzer AC, Iaccarino JM. Standardized Reporting and Management of Pulmonary Nodules: Integrating Care to Improve Outcomes. Chest 2021; 158:1824-1826. [PMID: 33160529 DOI: 10.1016/j.chest.2020.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 12/01/2022] Open
Affiliation(s)
- Anne C Melzer
- Division of Pulmonary, Allergy, Critical Care and Sleep, University of Minnesota, Minneapolis, MN; Minneapolis VA Health Care System, Minneapolis, MN.
| | | |
Collapse
|
8
|
Dyer DS, Zelarney PT, Carr LL, Kern EO. Improvement in Follow-up Imaging With a Patient Tracking System and Computerized Registry for Lung Nodule Management. J Am Coll Radiol 2021; 18:937-946. [PMID: 33607066 DOI: 10.1016/j.jacr.2021.01.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Despite established guidelines, radiologists' recommendations and timely follow-up of incidental lung nodules remain variable. To improve follow-up of nodules, a system using standardized language (tracker phrases) recommending time-based follow-up in chest CT reports, coupled with a computerized registry, was created. MATERIALS AND METHODS Data were obtained from the electronic health record and a facility-built electronic lung nodule registry. We evaluated two randomly selected patient cohorts with incidental nodules on chest CT reports: before intervention (September 2008 to March 2011) and after intervention (August 2011 to December 2016). Multivariable logistic regression was used to compare the cohorts for the main outcome of timely follow-up, defined as a subsequent report within 13 months of the initial report. RESULTS In all, 410 patients were included in the pretracker cohort versus 626 in the tracker cohort. Before system inception, 30% of CT reports lacked an explicit time-based recommendation for nodule follow-up. The proportion of patients with timely follow-up increased from 46% to 55%, and the proportion of those with no documented follow-up or follow-up beyond 24 months decreased from 48% to 31%. The likelihood of timely follow-up increased 41%, adjusted for high risk for lung cancer and age 65 years or older. After system inception, reports missing a tracker phrase for nodule recommendation averaged 6%, without significant interyear variation. CONCLUSIONS Standardized language added to CT reports combined with a computerized registry designed to identify and track patients with incidental lung nodules was associated with improved likelihood of follow-up imaging.
Collapse
Affiliation(s)
- Debra S Dyer
- Chair, Department of Radiology, National Jewish Health, Denver, Colorado.
| | | | - Laurie L Carr
- Past President, Medical Executive Committee; Division of Oncology, Department of Medicine, National Jewish Health, Denver, Colorado
| | - Elizabeth O Kern
- Chief, Division of Medical, Behavioral and Community Health, Department of Medicine; Past Chair, Institutional Review Board; Chair, Ethics Resource Committee, National Jewish Health, Denver, Colorado
| |
Collapse
|
9
|
Delaney FT, Lee JC. Reporting of Incidental Pulmonary Nodules Detected During Myocardial Perfusion Imaging. J Am Coll Radiol 2020; 17:981-982. [DOI: 10.1016/j.jacr.2020.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/03/2020] [Accepted: 04/07/2020] [Indexed: 11/27/2022]
|
10
|
Contextual Structured Reporting in Radiology: Implementation and Long-Term Evaluation in Improving the Communication of Critical Findings. J Med Syst 2020; 44:148. [PMID: 32725421 PMCID: PMC7387326 DOI: 10.1007/s10916-020-01609-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/15/2020] [Indexed: 11/18/2022]
Abstract
Structured reporting contributes to the completeness of radiology reports and improves quality. Both the content and the structure are essential for successful implementation of structured reporting. Contextual structured reporting is tailored to a specific scenario and can contain information retrieved from the context. Critical findings detected by imaging need urgent communication to the referring physician. According to guidelines, the occurrence of this communication should be documented in the radiology reports and should contain when, to whom and how was communicated. In free-text reporting, one or more of these required items might be omitted. We developed a contextual structured reporting template to ensure complete documentation of the communication of critical findings. The WHEN and HOW items were included automatically, and the insertion of the WHO-item was facilitated by the template. A pre- and post-implementation study demonstrated a substantial improvement in guideline adherence. The template usage improved in the long-term post-implementation study compared with the short-term results. The two most often occurring categories of critical findings are “infection / inflammation” and “oncology”, corresponding to the a large part of urgency level 2 (to be reported within 6 h) and level 3 (to be reported within 6 days), respectively. We conclude that contextual structured reporting is feasible for required elements in radiology reporting and for automated insertion of context-dependent data. Contextual structured reporting improves guideline adherence for communication of critical findings.
Collapse
|
11
|
Lee JC, Britten FL, Hartnett GF. Follow-up of incidental findings on positron emission tomography. World J Nucl Med 2020; 19:317-318. [PMID: 33354197 PMCID: PMC7745852 DOI: 10.4103/wjnm.wjnm_41_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/05/2020] [Accepted: 06/05/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Joseph C Lee
- Department of Medical Imaging, The Prince Charles Hospital, Chermside, Australia.,Faculty of Medicine, University of Queensland, Herston, Australia
| | - Fiona L Britten
- Faculty of Medicine, University of Queensland, Herston, Australia.,Department of Obstetric Medicine, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Gemma F Hartnett
- Faculty of Medicine, University of Queensland, Herston, Australia.,Department of Medical Oncology, Redcliffe General Hospital, Redcliffe, Queensland, Australia
| |
Collapse
|