Creating a disease-specific pulmonary embolism (PE) chest CT angiography (CTA) reporting template resulted in more complete studies, according to recent research. It also improved image quality.
A team from the University of Chicago’s Department of Radiology published their study online May 7 in the Journal of the American College of Radiology.
The primary goal of the study was to determine if utilization rates of chest CTA for detection of PE were appropriate. They also looked to see if if decreased variation in PE reporting. A separate area for pulmonary arterial findings was included in the new template, along with a summary section of PE-related findings after the impression.
Prior to the creation of the new template, CT PE reports were generated in a standard structured CT template—when 69.3 percent of those studies were considered “complete,” wrote corresponding author Jonathan H. Chung, MD, with U of C and colleagues.
After the new template was introduced, 96.1 percent of studies were deemed to be complete.
“The sudden desirable change in patient reporting behavior was not unprecedented. Multiple previous reports have described the value of a structured template in changing report completeness and quality,” Chung et al. wrote. “Most would agree that these gains come from the dual purpose of a structured template as a checklist or diagnostic algorithm, especially when used in a disease-specific manner, as in our case.”
Additionally, the team found many CT PE studies were not up to diagnostic quality standards. They used data gathered from their IT-based PE Tracker to find the timing of PE CT studies was to blame.
To decrease the variation in reporting, the group created a standard annotated document on how to properly perform a PE CT study, which was given to all technologists in the health system.
Data were collected for three months after this intervention, which showed a “significant” improvement in the indeterminate rate on CT. Despite this, authors noted a monthly variation in image quality as their health system grew.
“With a larger proportion of new CT technologists and acquisition of new CT scanners, an increase in variability is to be expected,” authors wrote. “However, we plan on acting on any adverse variations in clinical practice using our PE tracker quality assurance tool.”