Pancreatic surgeons give high marks to structured reporting

Structured reporting of results for multiphasic CT resulted in improved cancer reporting and surgery planning, according to a study published in the February edition of Radiology.

While previous studies have shown ordering clinicians prefer structured radiology reports, there had yet to be an objective look into the actual value that structured reports provide over more traditional, narrative-driven reports.

The authors, including Olga R. Brook, MD, of Beth Israel Deaconess Medical Center in Boston, sought to compare the contents of structured and unstructured CT reports and to assess the effect the reports had on tumor resectability for pancreatic surgeons.

The team studied 48 structured and 72 unstructured reports from multiphasic CTs conducted between 2006 and 2011 to gauge the impact of a 2008 implementation of a structured reporting template. Three pancreatic surgeons evaluated the reports on their accessibility.

Data for surgical planning was classified as “easily accessible” in 94 percent, 60 percent and 98 percent of the structured reports by the three surgeons, respectively. Non structured reports did not fare as well, with the three surgeons finding 47 percent, 54 percent and 32 percent, respectively, of the unstructured reports “easily accessible.” Additionally, the queried surgeons had “sufficient information” for surgical planning for 96 percent, 69 percent and 98 percent of structured and 31 percent, 43 percent and 25 percent of nonstructured reports, respectively.

The results, the authors wrote, confirmed that radiologists who relied on narrative reporting of multiphasic CT omitted key descriptors that surgeons sought while planning surgery for patients with pancreatic cancer. There was a statistical reduction in the number of descriptors omitted with the implementation of the template.

“Three key features in our template were omitted frequently in the nonstructured reports: presence of a replaced right hepatic artery, other aberrant anatomy, and atherosclerosis of the celiac axis,” Brooks and team wrote. “The 12 key features were not reported uniformly in every structured report because some radiologists perceived the information to be redundant.”

The authors also noted that structured reports lend themselves well to data analysis for quality assurance and improvement.

“An important aspect of quality improvement initiatives for reporting is reducing variability. We found a significant reduction in the variability of the number of key features included in the structured reports compared with that in the nonstructured reports,” they wrote.

Brooks and colleagues concluded that patient care stands to benefit from structured reporting, especially in the case of pancreatic multiphasic CT exams, as they better facilitate surgical planning than their unstructured counterparts.