Continued variation in radiology tech reports poses threat to readability

Anicka Slachta | July 17, 2018 | Radiology Business | Imaging Informatics

The lack of a structured reporting system for imaging technologists could be threatening the readability of studies in the field, a team of U.K. researchers reported this month in Radiography. But some argue a more rigid format would distract from the cognitive processes that make radiology reports so valuable in the first place.

Without a universal format—or even a lexicon of standard terms, as in the case with BI-RADS—writing radiology reports is seen as more of an art than a set process, corresponding author Anthony S. Manning-Stanley, a professor in the School of Health Sciences at the University of Liverpool, and colleagues wrote. For the most part, radiologists’ and technologists’ reporting styles are shaped by clinical experience and personal preferences.

“The written radiology report is the primary method for communicating the findings from imaging studies, and must accurately convey these findings to the referring physician in a timely manner,” wrote Manning-Stanley and his co-authors. “Given the range of stakeholders potentially receiving a radiological report, the use of unambiguous and clear language, as well as a focus on the salient findings, will ensure the meaning of the radiology report is not lost.”

Past research has noted stark differences in word count and word length in radiology reports, the authors wrote, especially when it comes to the divide between physician and trainee. Qualified radiologists tend to write more concise reports, while trainees are a little more long-winded.

Technologist—or radiographer—reporting is on the rise in the U.K., where the authors said tech reporting is to a standard comparable to radiologist reporting. The team focused on a major trauma center in the northwest of England for its research, where full reports for a year’s worth of 1,530 knee radiographic exams were analyzed for word count and length.

“Given radiographer reporting is well-established in the U.K., and is set to continue to play an important role in service delivery, further research is required in order to optimize the output of reporting radiographers, particularly in light of the variations in report structure noted for professional groups,” Manning-Stanley et al. wrote.

There were significant gaps between technologists when it came to average report length, according to the study. Reports ranged between 17 and 60 words, while average word length showed little variation. Four out of five techs always included a report title, the authors said, while three of five never included a signature.

Manning-Stanley and colleagues said it was common for technologists to leave out a conclusion or impression section in the report. Consistent with prior reports, more experienced technologists tended to write shorter reports than their trainee counterparts.

The authors said their results suggest a need for standardization, but that the idea’s been met with resistance. Experts have proposed standardizing terminology, recommendations and report formatting, much like BI-RADS or the more recently approved CAD-RADS, but no one knows if such an approach would result in benefits to patients. Others argue an itemized format would “interfere with the cognitive processes of reporting, taking the reporter’s gaze away from the images.”

Either way, Manning-Stanley et al. wrote, their work prompts more research.

“Further quantitative studies investigating the impact of the observed variation in report structure and length on patient outcomes are required, as well as the application on qualitative methods to investigate the drivers for the differences observed in this small group of reporting radiographers,” they said. “Given the strong negative correlation between experience and report length presented here, the influences on reporting style in reporting radiographers is also worthy of further investigation.”

Related CAD-RADS Content:

Related Content