Impact of an Information Technology–Enabled Initiative on the Quality of Prostate Multiparametric MRI Reports

Abstract

Rationale and Objectives Assess the impact of implementing a structured report template and a computer-aided diagnosis (CAD) tool on the quality of prostate multiparametric MRI (mp-MRI) reports. Materials and Methods Institutional Review Board approval was obtained for this HIPAA-compliant study performed at an academic medical center. The study cohort included all prostate mp-MRI reports (n=385) finalized 6 months before and after implementation of a structured report template and a CAD tool (collectively the IT tools) integrated into the PACS workstation. Primary outcome measure was quality of prostate mp-MRI reports. An expert panel of our institution’s subspecialty trained abdominal radiologists defined prostate mp-MRI report quality as optimal, satisfactory or unsatisfactory based on documentation of 9 variables. Reports were reviewed to extract the predefined quality variables and determine whether the IT tools were used to create each report. Chi-square and Student’s t-tests were used to compare report quality before and after implementation of IT tools. Results The overall proportion of optimal or satisfactory reports increased from 29.8% (47/158) to 53.3% (121/227) (p<0.001) after implementing the IT tools. While the proportion of optimal or satisfactory reports increased among reports generated using at least one of the IT tools (47/158=[29.8%] vs. 105/161=[65.2%]; p<0.001), there was no change in quality among reports generated without use of the IT tools (47/158=[29.8%] vs. 16/66=[24.2%]; p=0.404). Conclusion The use of a structured template and CAD tool improved the quality of prostate mp-MRI reports compared to free-text report format and subjective measurement of contrast enhancement kinetic curve.

Streamlining pre- and intra-hospital care for patients with severe trauma: a white paper from the European Critical Care Foundation

“…In the time-sensitive context of care for patients with severe trauma, clinical decisions are dependent on the expertise of the team leader and prone to errors. A clinical decision support system designed specifically for severe trauma has a high probability of improving the quality of the clinical decision and thus improving outcomes, as already demonstrated by several scientific reports [44,45]. An educational tool that includes the defragmentation of care in both initial and continuous medical training for severe trauma will be needed.…”

DCE-MRI, DW-MRI, and MRS in Cancer

“…Inter-observer variability is lower and clarity of communication among physicians improved for BI-RADS compared with unstructured reporting, with similar results seen for similar systems in other subspecialties. 84–86 Structured qualitative mpMRI reporting also increases efficiency of data mining and correlation with histopathology, enabling performance feedback for radiologists and systematic reader training. The importance of training is demonstrated by stronger reporting agreement between experienced readers than between less experienced readers, for whom rates of identifying and sampling malignant lesions (ie, accuracy) improve as their training progresses.…”

How are we going to train a generation of radiologists (and urologists) to read prostate MRI?

“…[5,8,[28][29][30][31][32]33 & ]. It has been proven that referring physicians prefer structured reports, and that structured reports are evidence of the reader's training and knowledge in the domain [34].…”

“…), and easy data collection or comparison. Therefore, according to most authors [1,2,[5][6][7]30,31,33 & ], its format has to be structured, and its content to be in a standardized and understandable terminology. We describe a framework and the fundamental content of a standardized prostate multiparametric-MRI report in Table 2.…”