Structured templates better than free text at producing outcomes-oriented radiology reports: study

Structured report templates don’t just improve the consistency of the structure and format of radiology reports sent to referring physicians. The templates also seem to prompt radiologists to better document data elements that are useful in helping guide referrers in making treatment decisions.

The effect was observed in a study of structured report templates as used in MRI reports for rectal cancer staging.

Writing in the September American Journal of Roentgenology, researchers from Harvard Medical School showed how the implementation and voluntary use of a structured report template for MRI for rectal cancer staging improved the quality of 106 MRI reports from 104 patients.

Led by Vikram Anik Sahni, MD, the authors, all from the department of radiology at Brigham and Women’s Hospital, applied 14 quality measures predefined by a consensus of the institution's abdominal radiology subspecialists.

They reported that, following voluntary use of the structured report template, the proportion of reports classified as optimal or satisfactory jumped from 38.5 percent to 70.4 percent.  

The authors suggested that, in cases wherein specific information is required in a radiology report to make care management decisions, using a structured report template “acts as an aide-mémoire for inclusion of the relevant imaging features and ensures that all the necessary information is imparted to the referring service in a clear and concise format.”

Rectal cancer staging MRI is one such examination, they point out, as the process involves reporting a multitude of objective data and thus lends itself to benefiting from a structured report format.

As strong as the positives were for structured reporting templates in the study, the quality of nearly 30 percent of reports remained unsatisfactory after implementation of the template.

For this and other reasons, including several limitations to the study, the authors call for additional research to assess whether adding quality-improvement strategies to structured report implementation will further boost report quality—and, if so, whether the lift will improve patient outcomes.