Many radiologists prefer to issue their reports in prose form, but clinicians tend to find structured reports clearer and easier to read, researchers from Singapore told delegates at the recent European Congress of Radiology (ECR) in Vienna.
A survey of clinicians and radiologists at Khoo Teck Puat Hospital, Singapore, found that clinicians had a significantly higher level of satisfaction with itemized reports than with those created in traditional prose format. Most radiologists, however, gravitated to the familiarity and perceived speed benefit of the prose reporting style, said Dr. Lin Wah Goh.
Seeking to compare the preferences of radiology reporting styles, Wah and senior consultant radiologist Dr. Hui-Seong Teh developed a cross-sectional survey that was sent to all radiologists and clinicians from various departments at their tertiary hospital.
The survey had two parts, the first of which covered demographics (clinical specialty of the clinician, number of years in practice of the radiologist, grade, and average number of reports read per week by the clinician). In the second part, respondents were given mock ultrasound and CT clinical scenarios and presented with sample reports in both itemized and prose formats. For each report, they were asked to rank their level of satisfaction for each report, ranging from very unsatisfied to very satisfied. Student's t-test was used to study significant differences between report formats.
Of the 250 clinicians who received questionnaires, 92 responded. All 30 radiologists responded. The radiologists had an average of 7.8 years of experience, with a range of 1-29 years.
Satisfied or very satisfied with prose reporting format
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Satisfied or very satisfied with itemized reporting format
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The differences between clinicians and radiologists were statistically significant for both formats (p<0.05).
Clinicians who preferred itemized reports found them easier to read and understand, while those radiologists who favored prose reports cited their familiarity and maintenance of narrative flow. Thirty percent of the radiologists said they use itemized reports in their daily reporting; 37% sometimes use itemized reports, and 33% did not use them at all.
The researchers found preferences for itemized reports by referring clinicians. Clinicians also tended to favor itemized reports when dealing with more complex exams, same as that found in corresponding studies, according to Goh. Report appearance, completeness, legibility, and inclusion of relevant data were cited as positive features for itemized reports.
The researchers also found that radiologists who did use itemized reporting said that it was faster to report and improved the clarity of their report. Those radiologists who didn't utilize itemized reports cited familiarity with the prose reporting style and said that itemized reporting slowed them down.
"As with any new technology, there maybe an initial increase in reporting times during the learning period, which will subsequently improve with experience," Goh said.
Previous research in the literature highlighted itemized reporting as the way for the future, she said. As a result, training of radiologists should include learning to report in this style.
"However, some radiologists may still find that reporting is an art and resist attempts at standardization," Goh said. "Itemized reporting is probably more [optimal] under the conditions that fit within the format of a template, while other conditions may require a tailor-made approach."
The economic and medico-legal aspects of using itemized reports needs to be assessed. She also acknowledged limitations of their study, including the small number of respondents and the early stage of the institution's implementation of itemized reporting.
