Structured reporting drops revision rate by 50% for CT angiography exams

Radiologists and referring physicians prefer structured reports—and they present concrete advantages to free-text alternatives. Recent research showed structured reports can reduce errors, help standardize resident training and improve recall of important information.

A study, published online May 9 in Current Problems in Diagnostic Radiology, found revision rates dropped by 50 percent for head and neck CT angiography (CTA) examinations when residents used a template.

“We believe structured reporting can benefit residents in terms of reinforcing concepts taught in the reading room,” wrote lead author Tucker F. Johnson, MD, and colleagues at Mayo Clinic in Rochester, Minnesota. “Residents continually find themselves rotating among vastly different areas of radiology throughout their training. Templates can be useful educational tools in allowing residents to develop search patterns and also to remind them of critical pathologies specific to certain examinations. It is important, however, that structured reporting strikes the right balance between being helpful and not overly burdensome.”

The research team developed a structured template for heat and neck CTA exams using Radiological Society of North America resources, while also consulting with neuroradiological staff at Mayo Clinic. It was available to residents for a two-month period. Baseline information was collected for two months before implementation.

Eleven of the 54 unstructured reports (20 percent) were revised during the baseline period. While the template was implemented, 58 reports were collected—41 unstructured and 17 structured. Revision rates dropped from 24 percent with free-text reports (10 of 41) to 12 percent with the template (two of 17).

Additionally, 86 percent of residents (25 of 29) believed structured reporting could minimize revision rates. The same number said the template was easier to use. Though authors noted the study was limited by its size, the results are encouraging for improving reporting.

“Creation of a structured template for reporting CTA head and neck examinations resulted in a reduction in reporting errors, particularly in terms of immaterial revisions for typographical errors,” wrote Johnson et al. “Based on these results and positive feedback received regarding the structured report, we plan to identify additional complex cross-sectional examinations that may benefit for structured templates at our institution.”