Radiology: Structured reportingthe way of the future
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Radiology reporting remains a non-standardized process with variations among providers and facilities. In addition, whether or not radiology reports meet the needs of customers, i.e. referring physicians, is open for debate.
Jan M. L. Bosmans, MD, from the department of radiology at Antwerp University Hospital and University of Antwerp in Belgium, and colleagues, designed a pair of surveys “to investigate and compare the opinions and expectations regarding the radiology report of radiologists and referring clinicians and to identify trends, discordance and discontent.”
The COVER (Clinicians’ Opinions, Views, and Expectations concerning the radiology Report) focused on demographic information, 46 statements scored via a Likert scale and a free response section. A similar survey, ROVER (Radiologists’ Opinions, Views, and Expectations concerning the radiology Report), targeted radiologists.
A total of 3,884 clinicians and 292 radiologists were invited to complete the surveys from the second half of 2008 to the first half of 2009. One hundred thirteen radiologists responded, along with 435 clinical specialists and 282 general practitioners.
Although the majority of all physicians disagreed with the question “Do clinicians feel they are better able to interpret an imaging study in their own discipline than radiologists,” nearly one-quarter of referring specialists indicated that they could better interpret a study in their specialty. Furthermore, 42.8 percent of specialists agreed that “radiology reports often mention important issues the clinicians would not have noticed on the images.” The corresponding rate among general practitioners was 84 percent.
There was less discordance regarding clinical information and clinical questions. Nearly all clinicians and radiologists agreed that the radiologist needs to know the clinical question the clinician wants answered.
While 71.8 percent of clinicians reported general satisfaction with the report, 26.8 percent of general practitioners indicated that reports were needlessly complicated. Half of clinicians felt that the language and style of the radiology report are mostly clear.
Nearly one-third of clinicians disagreed that radiologists proofread their reports thoroughly, and another half of respondents were neutral. In contrast, 68.4 percent of radiologists claimed thorough proofreading.
Opinions on itemized reporting diverged as well. Approximately 85 percent of clinicians would like to receive itemized reports, according to the authors, while 65.7 percent of radiologists would opt for itemized reporting.
Both clinicians and radiologists agreed that radiologists should receive instruction on report creation, with nearly 95 percent of both groups agreeing that “learning to report should be an obligatory and well-structured part of the training of future radiologists.”
Bosmans and colleagues offered several suggestions of improving the reporting process. These included:
- Radiologists should review images first and the clinical history second to overcome diagnostic bias.
- Clinicians should clearly state the desired information from the study.
- Tailoring the report to the profile of the referring physician might reduce dissatisfaction among clinicians, particularly general practitioners.
The authors also emphasized the need for improved training in reporting during the radiology residency and suggested an annual short course comprised of theoretical considerations and practical tips.
Bosmans shared four conclusions: physicians agreed that image interpretation is best left to radiologists, itemized reporting is the way of the future, the use of standardized language should be encouraged and radiologists should be trained in reporting.
Furthermore, the researchers noted that there will be multiple consequences for the practice and teaching of radiology and suggested that the profession evaluate the economic and medicolegal aspects of structured reporting.