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Interpreting the Interpretations: The Use of Structured Reporting Improves Referring Clinicians' Comprehension of Coronary CT Angiography Reports.
MedLine Citation:
PMID:  23485747     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Efficiency of coronary CT angiography (CCTA) in clinical practice depends on precise reporting and accurate result interpretation. OBJECTIVE: We sought to assess referring clinicians' understanding of patients' coronary artery disease (CAD) severity and to compare satisfactions of the free-form impression (FFI) with satisfactions of the structured impression (SI) section of CCTA reports. MATERIALS AND METHODS: Fifty clinical CCTA reports from May 2011 to April 2012 were retrospectively selected (25 FFI and 25 SI), to include cases with the entire spectrum of CAD (6 categories encompassing normal, minimal, mild, moderate, severe stenosis, and occlusion). A survey containing only randomized blinded impressions was distributed to 4 cardiologists and 2 cardiac imaging specialists. Clinician interpretation was examined regarding (Q1) worst stenosis severity, (Q2) number of vessels with significant stenosis, and (Q3) the presence of nonevaluable segments. Agreement proportions and Cohen's kappa were evaluated between FFI versus SI. Satisfactions were measured with respect to content, clarity, and clinical effectiveness. RESULTS: Q1 agreement was excellent for both FFI and SI (by 6 categories: 80% versus 85%; P > .05; kappa: 0.87 versus 0.89; by no CAD versus nonsignificant versus significant CAD: 99% versus 97%; P > .05; kappa: 0.99 versus 0.94). Q2 agreement improved from fair to moderate (53% versus 68%; P = .04; kappa 0.31 versus 0.52). Q3 agreement was moderate (90% versus 87%; P > .05; kappa 0.57 versus 0.58). Satisfactions with impressions were high and similar for FFI and SI for clinicians. CONCLUSION: Structured impressions were shown to improve result interpretation agreement from fair to moderate with regard to the number of vessels with significant stenosis.
Authors:
Brian B Ghoshhajra; Ashley M Lee; Maros Ferencik; Sammy Elmariah; Ronan J P Margey; Oyere Onuma; Marcello Panagia; Suhny Abbara; Udo Hoffmann
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-25
Journal Detail:
Title:  Journal of the American College of Radiology : JACR     Volume:  -     ISSN:  1558-349X     ISO Abbreviation:  J Am Coll Radiol     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-3-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101190326     Medline TA:  J Am Coll Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Affiliation:
Cardiac MR PET CT Program, Department of Radiology and Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
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