Can the completeness of radiological cancer staging reports be improved using proforma reporting? A prospective multicentre non-blinded interventional study across 21 centres in the UK

Abstract

ObjectivesFollowing a diagnosis of cancer, the detailed assessment of prognostic stage by radiology is a crucial determinant of initial therapeutic strategy offered to patients. Pretherapeutic stage by imaging is known to be inconsistently documented. We tested whether the completeness of cancer staging radiology reports could be improved through a nationally introduced pilot of proforma-based reporting for a selection of six common cancers.DesignProspective interventional study comparing the completeness of radiology cancer staging reports before and after the introduction of proforma reporting.SettingTwenty-one UK National Health Service hospitals.Participants1283 cancer staging radiology reports were submitted.Main outcome measuresRadiology staging reports across the six cancers types were evaluated before and after the implementation of proforma-based reporting. Report completeness was assessed using scoring forms listing the presence or absence of predetermined key staging data. Qualitative data regarding proforma implementation and usefulness were collected from questionnaires provided to radiologists and end-users.ResultsElectronic proforma-based reporting was successfully implemented in 15 of the 21 centres during the evaluation period. A total of 787 preproforma and 496 postproforma staging reports were evaluated. In the preproforma group, only 48.7% (5586/11 470) of key staging items were present compared with 87.3% (6043/6920) in the postproforma group. Thus, the introduction of proforma reporting produced a 78% improvement in staging completeness. This increase was seen across all cancer types and centres. The majority of participants found proforma reporting improved cancer reporting quality for their clinical practice.ConclusionThe implementation of proforma reporting results in a significant improvement in the completeness of cancer staging reports. Proforma-based assessment of cancer stage enables objective comparisons of patient outcomes across centres. It should therefore become an auditable quality standard for cancer care.

Structured Reporting in Cross-Sectional Imaging of the Heart: Reporting Templates for CMR Imaging of Cardiomyopathies (Myocarditis, Dilated Cardiomyopathy, Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Cardiomyopathy and Siderosis)

“…To date, the majority of radiological reports are written in the form of non-standardized free text. A number of studies have demonstrated that the use of standardized reporting templates offer advantages for both the reporting and communication of findings [1][2][3][4][5]. Thematic structure, pre-formulated text modules, categorized diagnoses and uniform terminology can increase the time efficiency in the preparation of reports, while standardization can help ensure consistent quality with respect to comprehensibility, clarity, completeness and clinical relevance of the reports [6,7].…”

“…4 Only required when extracellular volume (ECV) is to be stated in Special Part (optional for "Myocarditis", "DCM" reporting templates). 5 Free text for description of artifacts and cause (e. g. arrhythmia, limited patient compliance), including resulting limitations on conclusive assessment. 6 Indication of (age and gender-specific) normal values according to source cited in "Technique", e. g. selection from [21].…”

“…4 In addition, indication of hemodynamic relevance according to [20]. 5 In addition, indication of max. pericardial thickness according to [20].…”

“…Minor criterion: Regional RV akinesia or dyskinesia or dyssynchronous RV contraction and Ratio of RV EDV to BSA ≥ 100 to < 100 mL/m 2 (male) or ≥ 90 to < 100 mL/m 2 (female) or RV ejection fraction > 40 % to ≤ 45 %. 5 Indication of presence of task force and non-task force criteria (ARVD-typical pattern of fat infiltration and/or non-ischemic LGE) [34], Free text for secondary findings.…”

The Oncologist’s Guide to Synoptic Reporting: A Primer

“…While the historic origin and widest application of synoptic reporting are in oncologic pathology, its concepts are spreading to non-neoplastic pathology [22,23] as well as oncologic specialities other than pathology. Main areas of application of synoptic reporting include radiology [24][25][26][27][28] and operative reports in surgery [29][30][31][32][33][34]. While the overall number of studies addressing the effects of synoptic reporting is considerably lower than in pathology, they tend to show similar outcomes; completeness of reports increases with the use of synoptic reporting, while at the same time the amount of non-essential information is reduced [35][36][37].…”