Structured reporting in cardiovascular computed tomography

Plum, Jessica (2019): Structured reporting in cardiovascular computed tomography. Dissertation, LMU München: Medizinische Fakultät

Abstract

While investigation techniques and image modalities become more and more advanced, radiology reports have remained in their classic form for the past decades. Structured reporting has shown its potential to increase the clarity, correctness, confidence, concision, completeness, consistency, communication, consultation and standardization of radiology reports. The increased report quality can mostly be attributed to a complete checklist like approach, standardized vocabulary through RadLex and RSNA provided templates which can be adapted to address very specific inquiries. Especially the interdisciplinary approach necessary to design and adapt those templates can ensure that all therapy influencing criteria are evaluated in the report. This may lead to a different therapy and outcome. Structured reporting also harbors great teaching opportunities, such as a checklist-like approach for young radiology residents and an image database of pathological findings. With a large analyzable database of reports, a statistical analysis becomes possible, which can e.g. lead to increasingly better screening algorithms. Technological challenges however, different data formats, varying degrees of quality of structured reporting systems and the concerns about work flow efficiency and report rigidity remain difficulties of structured reporting itself. Despite of this it also provides many future possibilities such as the implementation of medical guide lines into the report format, multi media reports, evaluation of radiation dose, management of follow-up appointments, automatic invoice and reimbursement systems and the improvement of data mining. Given the potential of structured reporting and its impact on patient care, we decided to evaluate its so far unknown benefit for patients with acute PE and PAD. For patients with APE, the structured reports were evaluated by two pulmonologists and two general internists and compared to the reports from the clinical routine of the same patient group. While all four referring clinicians perceived the structured CTPA reports as superior in clarity, only the pulmonologists found additional benefit in content and clinical utility. The structured reports did not alter patients’ management in patients with acute PE significantly. In the study concerning patients with diagnosed or suspected PAD the structured reports (run-off CTA/ lower extremities) were evaluated by two vascular surgeons and two vascular medicine specialists. The results showed, both groups regarded structured reports as superior in clarity, completeness, clinical relevance and usefulness. Especially vascular medicine specialists seemed to appreciate the structured reporting format. As in our PE study, structured reporting did not seem to alter further testing or therapy for the patients included in our study. Both studies demonstrate that referring clinicians prefer structured reporting of cardiovascular CT examinations over conventional reports.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Keywords: Structured Reporting, PAD, LAE, Cardiovascular Computed Tomography
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Englisch
• Datum der mündlichen Prüfung: 6. Juni 2019
• 1. Bericht­erstatter:in: Meinel, Felix