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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.
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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
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Brendle C, Bender B, Selo N, Poli S, Tünnerhoff J, Huber T, Kirschke J, Boeckh-Behrens T, Pinto Dos Santos D, Wiest R, Berlis A, Liebig T, Korczynski O, Ernemann U, Hempel JM. Structured Reporting of Acute Ischemic Stroke - Consensus-Based Reporting Templates for Non-Contrast Cranial Computed Tomography, CT Angiography, and CT Perfusion. ROFO-FORTSCHR RONTG 2021; 193:1315-1317. [PMID: 34265854 DOI: 10.1055/a-1487-6849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Structured reporting is an essential step in establishing standardized quality standards in diagnostic radiology. The German Society of Radiology and the German Society of Neuroradiology aim to provide templates for the structured reporting of different radiological examinations. METHOD The Information Technology working group of the German Society of Radiology developed structured templates for the radiological reporting of different indications in consensus with specialist support by experts. RESULTS We present a template for the structured reporting of examinations of patients with acute ischemic stroke by non-contrast computed tomography, CT angiography, and CT perfusion. This template is provided on the website www.befundung.drg.de for free use. CONCLUSION Implementation of the structured template may increase quality and provide a minimum standard for radiological reports in patients with acute ischemic stroke. KEY POINTS · The German Society of Radiology and the German Society of Neuroradiology are providing support for the development of structured templates in German.. · We present a template for the structured reporting of examinations of patients with acute ischemic stroke by non-contrast computed tomography, CT angiography, and CT perfusion. This template is provided on the website www.befundung.drg.de for free use.. · Implementation of the structured template may increase quality and provide a minimum standard for radiological reports in patients with acute ischemic stroke.. CITATION FORMAT · Brendle C, Bender B, Selo N et al. Structured Reporting of Acute Ischemic Stroke - Consensus-Based Reporting Templates for Non-Contrast Cranial Computed Tomography, CT Angiography, and CT Perfusion. Fortschr Röntgenstr 2021; 193: 1315 - 1317.
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Affiliation(s)
- Cornelia Brendle
- Radiologische Universitätsklinik Tübingen, Abteilung Diagnostische und Interventionelle Neuroradiologie, Tübingen, Deutschland
| | - Benjamin Bender
- Radiologische Universitätsklinik Tübingen, Abteilung Diagnostische und Interventionelle Neuroradiologie, Tübingen, Deutschland
| | - Nadja Selo
- Radiologische Universitätsklinik Tübingen, Abteilung Diagnostische und Interventionelle Neuroradiologie, Tübingen, Deutschland
| | - Sven Poli
- Universitätsklinikum Tübingen, Abteilung Neurologie mit Schwerpunkt neurovaskuläre Erkrankungen, Tübingen, Deutschland.,Universitätsklinikum Tübingen, Hertie-Institut für klinische Hirnforschung, Tübingen, Deutschland
| | - Johannes Tünnerhoff
- Universitätsklinikum Tübingen, Abteilung Neurologie mit Schwerpunkt neurovaskuläre Erkrankungen, Tübingen, Deutschland.,Universitätsklinikum Tübingen, Hertie-Institut für klinische Hirnforschung, Tübingen, Deutschland
| | - Thomas Huber
- Universitätsmedizin Mannheim, Klinik für Radiologie und Nuklearmedizin, Mannheim, Deutschland
| | - Jan Kirschke
- Klinikum rechts der Isar, Technische Universität München, Neuro-Kopf-Zentrum, Abteilung Diagnostische und Interventionelle Neuroradiologie, München, Deutschland
| | - Tobias Boeckh-Behrens
- Klinikum rechts der Isar, Technische Universität München, Neuro-Kopf-Zentrum, Abteilung Diagnostische und Interventionelle Neuroradiologie, München, Deutschland
| | - Daniel Pinto Dos Santos
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln, Deutschland
| | - Roland Wiest
- Inselspital Bern, Universitätsinstitut für Diagnostische und Interventionelle Neuroradiologie, Bern, Schweiz
| | - Ansgar Berlis
- Universitätsklinikum Augsburg, Klinik für Diagnostische und Interventionelle Neuroradiologie, 8 Universitätsklinikum Augsburg, Klinik für Diagnostische und Interventionelle Neuroradiologie, Augsburg, Deutschland
| | - Thomas Liebig
- Ludwig-Maximilians-Universität München, Institut für Diagnostische und Interventionelle Neuroradiologie, Klinikum Großhadern, München, Deutschland
| | - Oliver Korczynski
- Universitätsmedizin Mainz, Klinik und Poliklinik für Neuroradiologie, Mainz, Deutschland
| | - Ulrike Ernemann
- Radiologische Universitätsklinik Tübingen, Abteilung Diagnostische und Interventionelle Neuroradiologie, Tübingen, Deutschland
| | - Johann-Martin Hempel
- Radiologische Universitätsklinik Tübingen, Abteilung Diagnostische und Interventionelle Neuroradiologie, Tübingen, Deutschland
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Patil S, Yacoub JH, Geng X, Ascher SM, Filice RW. Radiology Reporting in the Era of Patient-Centered Care: How Can We Improve Readability? J Digit Imaging 2021; 34:367-373. [PMID: 33742332 PMCID: PMC8289949 DOI: 10.1007/s10278-021-00439-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 01/21/2021] [Accepted: 02/24/2021] [Indexed: 10/21/2022] Open
Abstract
Radiology reports are consumed not only by referring physicians and healthcare providers, but also by patients. We assessed report readability in our enterprise and implemented a two-part quality improvement intervention with the goal of improving report accessibility. A total of 491,813 radiology reports from ten hospitals within the enterprise from May to October, 2018 were collected. We excluded echocardiograms, rehabilitation reports, administrator reports, and reports with negative scores leaving 461,219 reports and report impressions for analysis. A grade level (GL) was calculated for each report and impression by averaging four readability metrics. Next, we conducted a readability workshop and distributed weekly emails with readability GLs over a period of 6 months to each attending radiologist at our primary institution. Following this intervention, we utilized the same exclusion criteria and analyzed 473,612 reports from May to October, 2019. The mean GL for all reports and report impressions was above 13 at every hospital in the enterprise. Following our intervention, a statistically significant drop in GL for reports and impressions was demonstrated at all locations, but a larger and significant improvement was observed in impressions at our primary site. Radiology reports across the enterprise are written at an advanced reading level making them difficult for patients and their families to understand. We observed a significantly larger drop in GL for impressions at our primary site than at all other sites following our intervention. Radiologists at our home institution improved their report readability after becoming more aware of their writing practices.
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Affiliation(s)
- Siya Patil
- Georgetown University School of Medicine, 3900 Reservoir Rd NW, Washington DC, 20007, USA
| | - Joseph H Yacoub
- Department of Radiology, MedStar Georgetown University Hospital, 3900 Reservoir Rd NW, Washington DC, 20007, USA
| | - Xue Geng
- Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University Medical Center, 3900 Reservoir Rd NW, Washington DC, 20007, USA
| | - Susan M Ascher
- Department of Radiology, MedStar Georgetown University Hospital, 3900 Reservoir Rd NW, Washington DC, 20007, USA
| | - Ross W Filice
- Department of Radiology, MedStar Georgetown University Hospital, 3900 Reservoir Rd NW, Washington DC, 20007, USA.
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Kelsch R, Saon M, Sutherland E, Tech K, Al-Katib S. Discrepant Reporting Style Preferences Between Clinicians and Radiologists. Curr Probl Diagn Radiol 2020; 50:779-783. [PMID: 33272722 DOI: 10.1067/j.cpradiol.2020.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/16/2020] [Indexed: 12/13/2022]
Abstract
RATIONALE AND OBJECTIVES To compare preferences in reporting styles between radiologists and clinicians in structured vs unstructured reporting styles in order to facilitate better communication. METHODS An online survey was distributed to 5280 clinicians, radiologists, and physicians in training surveying respondent preference for three different reporting styles: expanded structured, minimized structured, and unstructured. RESULTS A 7.5% response rate was achieved. Overall, the expanded structured reporting style was the most preferred (47%, 186/394). This contrasted with radiologists who preferred the unstructured reporting style (41%), whereas nonradiologists preferred the expanded structured reporting style (51%; P < 0.001). There was significance in emergency medicine physicians preferring the minimized structured reporting style (51%, 27/43), whereas all other specialties preferred the expanded structured report (49%, 168/341; P = 0.0038). DISCUSSION There is a discrepant reporting style preference between clinicians and radiologists. A structured reporting style with expanded standard statements is preferred by most physicians. Radiologists could consider using a structured reporting style with minimized normal statements in the emergency room setting.
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Affiliation(s)
- Ryan Kelsch
- Department of Diagnostic Radiology and Molecular Imaging, Beaumont Health, Royal Oak, MI.
| | - Md Saon
- Department of Diagnostic Radiology and Molecular Imaging, Beaumont Health, Royal Oak, MI
| | - Edward Sutherland
- Department of Diagnostic Radiology and Molecular Imaging, Beaumont Health, Royal Oak, MI
| | - Kurt Tech
- Department of Diagnostic Radiology and Molecular Imaging, Beaumont Health, Royal Oak, MI
| | - Sayf Al-Katib
- Department of Diagnostic Radiology and Molecular Imaging, Beaumont Health, Royal Oak, MI
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Unread Second-Opinion Radiology Reports: A Potential Waste of Health Care Resources. AJR Am J Roentgenol 2020; 215:934-939. [PMID: 32783557 DOI: 10.2214/ajr.19.22662] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE. The purpose of this study was to investigate how frequently second-opinion radiology reports are not read by clinicians and to identify reasons why reports are not read. MATERIALS AND METHODS. This retrospective study included 4696 consecutive second-opinion reports of external imaging examinations that were authorized by subspecialty radiologists at a tertiary care institution over a 1-year period. RESULTS. Of 4696 second-opinion reports, 537 were not read by a clinician, corresponding to a frequency of 11.4% (95% CI, 10.6-12.3%). On multivariate logistic regression analysis, five variables were significantly and independently associated with the second-opinion report not being read: inpatient status (odds ratio [OR], 163.26; p < 0.001), sonography as the imaging modality (OR, 5.07; p = 0.014), surgery (OR, 0.18; p < 0.001) or neurology (OR, 2.82; p < 0.001) as the requesting clinician's specialty, and interventional radiology as the subspecialty of the radiologist who authorized the second-opinion report (OR, 3.52; p = 0.047). We found no significant independent associations between the clinician not reading the second-opinion report and patient age, patient sex, or time between submission of the second-opinion request and finalization of the report. CONCLUSION. A considerable proportion of second-opinion reports are not read by clinicians, which represents an appreciable but potentially reversible waste of health care resources. The reasons why clinicians do not read reports need to be investigated in future studies. If subspecialty radiologists and clinicians take the proven determinants into account, the amount of second-opinion readings with limited additional clinical value may be reduced.
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