RI-RADS could improve radiologists’ imaging orders

A new standardized system to grade imaging orders proposed by authors of a piece published in the European Journal of Radiology might help improve the quality of radiology orders and patient care as a whole.

The Reason for exam Imaging Reporting and Data System (RI-RADS) operates much like other standardized reporting systems such as the Breast Imaging Reporting and Data System (BI-RADS) and Liver Imaging Reporting and Data System (LI-RADS) in that it improves communication between radiologists and referring clinicians. RI-RADS focuses specifically on three categories of information: impression, clinical findings and the diagnostic question.

“The rationale behind this new system is that, ideally, an imaging requisition should contain enough patient information and clinical context to enable radiologists to recognize the precise intent of the study, wrote Aidin Abedi, MD, Keck School of Medicine at the University of Southern California in Los Angeles, and colleagues.

This pertinent clinical information should include: indication for the exam, working diagnosis, chronicity, and location of signs and symptoms, mechanism of ailment, pertinent positives and negatives, any pertinent lab values, pertinent past medical and surgical histories, and any other significant clinical information.”

RI-RADS would focus only on information in the requisition form, the authors noted. It would grade an order based on if it included information from the three categories mentioned above. If an order did in fact include all needed information it would earn a grade of RI-RADS A, determined to be “adequate.” Other grades include a RI-RADS B (“barely adequate”), RI-RADS C (“considerably limited”) and RI-RADS D (“deficient).

Down the line, RI-RADS could become a separate section of imaging reports, the researchers noted. Those with this extra information will promote regular feedback from radiologists which can be gathered into a provider “report card” to see how robust a referring physicians’ requisition is compared to their colleagues.

“With continuous feedback, clinicians may be encouraged to provide the best clinical information possible, leading to improved efficacy for the radiologists reviewing studies and better patient care,” Abedi et al. wrote.

As with any other classification system, the authors wrote, it’s important to test RI-RADS with independent experts before implementing the system in a clinical setting. Abedi et al. plan to take these steps and believe their proposed system could have a positive impact.

“This simple and comprehensive system may increase the accuracy and efficiency of the interpretations, improve the interdisciplinary communications, and most importantly improve patient care,” the researchers concluded.