Survey shows emergency physicians value clarity, timeliness in structured reporting

In a survey of imaging reporting types, physicians in an emergency setting indicated a preference for an itemized structured report, which beat out both basic structured reporting and a newly-developed interactive point-and-click report, according to results published online March 7 in Academic Radiology.

“Quality clinical care provided through the use of imaging reports depends on the reports' timeliness and accuracy as much as their clarity and consistency. The need for clarity and consistency of imaging reports is a major driver for the radiology practice to change from conventional free-text reporting to a structured reporting pattern,” wrote Naree Manoonchai, MD, and colleagues from Ramathibodi Hospital in Bangkok, Thailand.

To assess reporting preferences in the emergency setting at their institution, Manoonchai and colleagues created a survey that was completed by 101 physicians. Of the respondents, 61 were radiologists and 40 were referring physicians, and 81 were trainees while 20 were attending.

The survey was administered one month after the September 2013 roll-out of a point-and-click report type that was introduced with the development of the Breast Imaging Reporting and Data System and styled after Radiological Society of North America report templates. These reports provided clickable options of standardized text rather than requiring physicians to dictate or type responses.

Point-and-click reports were compared against basic structured reporting, which consisted only of rudimentary standardized headings, and itemized structured reports, which further refined the basic reports by adding additional subheadings.

Overall scores showed a slight preference for itemized reports over point-and-click reports, with basic structured reports lagging behind in both quality and process. Quality scores (out of five) were 4.03-4.37 for itemized reports, 3.32-4.52 for point-and-click, and 2.59-3.86 for basic reports. Evaluations of process were scored at 3.80-4.56, 2.79-4.09, and 2.32-3.56, respectively.

Manoonchai and colleagues said the survey also indicated differences in what referrers and radiologists valued in a report format.

“For referring physicians working in this setting, report readability, easiness in finding an answer to a clinical question, and completeness are crucial for case management,” wrote the authors. “In view of emergency radiologists, ability to efficiently render imaging reports in a timely manner, with minimal loss of information, in a standardized format is similarly important.”

While newer point-and-click style reports were liked by radiologists, the authors said a limited number of templates and unfamiliar user interface kept it from being the most-liked reporting pattern.