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Structured reporting of CT enterography for inflammatory bowel disease: effect on key feature reporting, accuracy across training levels, and subjective assessment of disease by referring physicians

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Abstract

Purpose

To compare the content and accuracy of structured reporting (SR) versus non-structured reporting (NSR) for computed tomographic enterography (CTE) of inflammatory bowel disease (IBD).

Materials and methods

This IRB-approved, HIPAA-compliant, retrospective study included 30 adult subjects (15 male, 15 female; mean age 41.9 years) with IBD imaged with CTE. Nine radiologists (3 faculty, 3 abdominal imaging fellows, and 3 senior radiology residents) independently interpreted all examinations using both NSR and SR, separated by four weeks. Reports were assessed for documentation of 15 key reporting features and a subset of 5 features was assessed for accuracy. Thirty faculty reports (15 NSR [5 per reader] and 15 SR [5 per reader]) were randomly selected for review by three referring physicians, who independently rated quality metrics for each report.

Results

NSR documented the presence or absence of 8.2 ± 2.2 key features, while SR documented 14.6 ± 0.5 features (p < 0.001). SR resulted in increased documentation of 13 of 15 features including stricture (p < 0.001), fistula (p < 0.001), fluid collection (p = 0.003), and perianal disease (p < 0.001). Among a subset of five features, accuracy for diagnosing multifocal disease was minimally increased when using SR (76% NSR vs. 83% SR; p = 0.01), but accuracy for other features was not affected by report type. Referring physicians significantly preferred SR based on ease of information extraction (p < 0.01).

Conclusion

Structured reporting of CTE for IBD improved documentation of key reporting features for trainees and faculty, though there was minimal impact on accuracy. Referring physicians subjectively preferred the structured reports.

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Authors and Affiliations

  1. Department of Radiology, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA

    Benjamin Wildman-Tobriner, Brian C. Allen, Mustafa R. Bashir, Morgan Camp, Chad Miller, Alan Cubre, Alex D. Bibbey, Wendy L. Ehieli, Maciej Mazurowski & Tracy A. Jaffe

  2. Center for Advanced Magnetic Resonance Development, Duke University Medical Center, 2301 Erwin Rd, Durham, NC, 27710, USA

    Mustafa R. Bashir

  3. Department of Radiology, Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Columbus, OH, 43210, USA

    Lauren E. Fiorillo

  4. Department of Radiology, University of Texas MD Anderson, 1400 Pressler Street, Unit 1459, Houston, TX, 77030, USA

    Sanaz Javadi

  5. Department of Gastroenterology, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA

    Nancy McGreal & Reinaldo Quevedo

  6. Department of Surgery, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27710, USA

    Julie K. Thacker

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  1. Benjamin Wildman-Tobriner
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Correspondence to Benjamin Wildman-Tobriner.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Statement of informed consent was not applicable since the manuscript does not contain any patient data.

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Wildman-Tobriner, B., Allen, B.C., Bashir, M.R. et al. Structured reporting of CT enterography for inflammatory bowel disease: effect on key feature reporting, accuracy across training levels, and subjective assessment of disease by referring physicians. Abdom Radiol 42, 2243–2250 (2017). https://doi.org/10.1007/s00261-017-1136-1

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