Six Characteristics of Effective Structured Reporting and the Inevitable Integration with Speech Recognition

Abstract

The reporting of radiological images is undergoing dramatic changes due to the introduction of two new technologies: structured reporting and speech recognition. Each technology has its own unique advantages. The highly organized content of structured reporting facilitates data mining and billing, whereas speech recognition offers a natural succession from the traditional dictation-transcription process. This article clarifies the distinction between the process and outcome of structured reporting, describes fundamental requirements for any effective structured reporting system, and describes the potential development of a novel, easy-to-use, customizable structured reporting system that incorporates speech recognition. This system should have all the advantages derived from structured reporting, accommodate a wide variety of user needs, and incorporate speech recognition as a natural component and extension of the overall reporting process.

ACCF/ACR/AHA/ASE/ASNC/HRS/NASCI/RSNA/SAIP/SCAI/SCCT/SCMR 2008 Health Policy Statement on Structured Reporting in Cardiovascular Imaging

“…[3][4][5][6] Imaging quality may be improved and QI activities may be facilitated through imposed consistency of structured data collection and reporting. Key report components and data elements will not be omitted if the report is structured and elements are listed systematically within a standard template.…”

Using Natural Language Processing to Extract Abnormal Results From Cancer Screening Reports

“…As a result, the full benefit of using standard lexicons to report results are not realized. 22,23 A major barrier to structured reporting can be found in current adoption patterns in which breast imaging, cardiology, and gastroenterology are the most common use cases. 24 Diagnostic reports in these disciplines describe well-circumscribed anatomical sites that are subject to fairly narrow pathologies, thus making results reporting conducive to manageable structured templates.…”

The need for standardization of nuclear cardiology reporting and data system (NCAD-RADS): Learning from coronary artery disease (CAD), breast imaging (BI), liver imaging (LI), and prostate imaging (PI) RADS

“…The use of a standardized and consistent language style has been demonstrated to promote diagnostic interpretation, improve interobserver consistency, and allow for easier data retrieval and billing while reducing turnaround time and decreasing typographic and dictation errors. 9,27 Moreover, studies have depicted that consistent terminology can add emphasis to the interpreting radiologist's confidence, considerably influencing a clinician's decision to follow a radiologist's recommendations. 28 Structured reporting has also been shown to help improve auditing and analysis of data through the application of distinguishable and consistent terminology, which has opened up new and more simplified avenues for research and quality improvement.…”