Structured reporting of CT enterography for inflammatory bowel disease: effect on key feature reporting, accuracy across training levels, and subjective assessment of disease by referring physicians.
Abdom Radiol (NY). 2017 Apr 9. doi: 10.1007/s00261-017-1136-1. [Epub ahead of print] Wildman-Tobriner B1, Allen BC2, Bashir MR2,3, Camp M2, Miller C2, Fiorillo LE4, Cubre A2, Javadi S5, Bibbey AD2, Ehieli WL2, McGreal N6, Quevedo R6, Thacker JK7, Mazurowski M2, Jaffe TA2.
PURPOSE: To compare the content and accuracy of structured reporting (SR) versus non-structured reporting (NSR) for computed tomographic enterography (CTE) of inflammatory bowel disease (IBD).
MATERIALS AND METHODS: This IRB-approved, HIPAA-compliant, retrospective study included 30 adult subjects (15 male, 15 female; mean age 41.9 years) with IBD imaged with CTE. Nine radiologists (3 faculty, 3 abdominal imaging fellows, and 3 senior radiology residents) independently interpreted all examinations using both NSR and SR, separated by four weeks. Reports were assessed for documentation of 15 key reporting features and a subset of 5 features was assessed for accuracy. Thirty faculty reports (15 NSR [5 per reader] and 15 SR [5 per reader]) were randomly selected for review by three referring physicians, who independently rated quality metrics for each report.
RESULTS: NSR documented the presence or absence of 8.2 ± 2.2 key features, while SR documented 14.6 ± 0.5 features (p < 0.001). SR resulted in increased documentation of 13 of 15 features including stricture (p < 0.001), fistula (p < 0.001), fluid collection (p = 0.003), and perianal disease (p < 0.001). Among a subset of five features, accuracy for diagnosing multifocal disease was minimally increased when using SR (76% NSR vs. 83% SR; p = 0.01), but accuracy for other features was not affected by report type. Referring physicians significantly preferred SR based on ease of information extraction (p < 0.01).
CONCLUSION: Structured reporting of CTE for IBD improved documentation of key reporting features for trainees and faculty, though there was minimal impact on accuracy. Referring physicians subjectively preferred the structured reports.