Itemized Reporting A Must For Radiologists

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imageImage interpretation should remain a task solely for radiologists, who should utilize itemized reporting and standardized language to produce clear and unequivocal reports, according to results of two surveys published in the April edition of Radiology. The surveys—dubbed “Clinicians’ Opinions, Views, and Expectations Concerning the Radiology Report” (COVER) and “Radiologists’ Opinions, Views, and Expectations Concerning the Radiology Report” (ROVER)--were designed by Jan M. L.Bosmans, MD, of the department of radiology at Antwerp University Hospital and the University of Antwerp in Belgium, and colleagues. Their intent, the Radiology report indicates, was “to investigate and compare the opinions and expectations regarding the radiology report of radiologists and referring clinicians and to identify trends, discordance and discontent.” A total of 3,884 clinicians and 292 radiologists were invited to complete the surveys from the second half of 2008 through the first half of 2009, with 113 radiologists, 435 clinical specialists, and 282 general practitioners opting to do so. 

A majority of all physicians responding to the surveys disagreed with the question “Do clinicians feel they are better able to interpret an imaging study in their own discipline than radiologists?”, but nearly one-quarter of referring specialists indicated that they could better interpret a study in their specialty. Almost one-half (42.8%) of specialists and 84% of general practitioners said radiology reports “often mention important issues the clinicians would not have noticed on the images.” Participants expressed more consistent responses regarding clinical information and clinical questions; nearly all clinicians and radiologists concurred that the radiologist must be aware of the clinical question the clinician wants answered. 

In addition, while 71.8% of clinicians reported general satisfaction with radiology reports, 26.8% of general practitioners deemed them “needlessly complicated”. Of clinicians surveyed, half expressed the viewpoint that the language and style used in the reports is “mostly clear”. Nearly one-third of clinicians disagreed that radiologists proofread their reports thoroughly, and another half of respondents were neutral. Conversely, 68.4% of radiologists claimed that thorough proofreading is a regular practice for them. 

Moreover, opinions on itemized reporting differed among respondent sectors. Approximately 85% of clinicians would like to receive itemized reports, the authors state, but fewer radiologists--67.5%--said they would opt for it Clinicians and radiologists alike believe radiologists should receive instruction on report creation, with nearly 95% of both groups noting that “learning to report should be an obligatory and well-structured part of the training of future radiologists.”

 To improve the reporting process, Bosmans and colleagues note, radiologists should review images first and clinical history second to overcome diagnostic bias, while clinicians should clearly state the desired information from the study. Tailoring reports to the profile of the referring physician might reduce dissatisfaction among clinicians, particularly general practitioners, the researchers contend. The latter expressed both hope and cynicism about itemized reporting, noting that current systems “are time-consuming and detract the radiologist from the core task of analyzing and interpreting the images”, but “talking templates and automatic transcription of natural speech may partially address the shortcomings”. The authors also emphasize the need for improved training in reporting during the radiology residency and suggest an annual short course comprised of theoretical considerations and practical tips.