Skip to main content
SpringerLink
Log in

Structured reporting of MRI of the shoulder – improvement of report quality?

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To evaluate the effect of structured reports (SRs) in comparison to non-structured narrative free text (NRs) shoulder MRI reports and potential effects of both types of reporting on completeness, readability, linguistic quality and referring surgeons’ satisfaction.

Methods

Thirty patients after trauma or with suspected degenerative changes of the shoulder were included in this study (2012–2015). All patients underwent shoulder MRI for further assessment and possible surgical planning. NRs were generated during clinical routine. Corresponding SRs were created using a dedicated template. All 60 reports were evaluated by two experienced orthopaedic shoulder surgeons using a questionnaire that included eight questions.

Results

Eighty per cent of the SRs were fully complete without any missing key features whereas only 45% of the NRs were fully complete (p < 0.001). The extraction of information was regarded to be easy in 92% of the SRs and 63% of the NRs. The overall quality of the SRs was rated better than that of the NRs (p < 0.001).

Conclusions

Structured reporting of shoulder MRI improves the readability as well as the linguistic quality of radiological reports, and potentially leads to a higher satisfaction of referring physicians.

Key Points

• Structured MRI reports of the shoulder improve readability.

• Structured reporting facilitates information extraction.

• Referring physicians prefer structured reports to narrative free text reports.

• Structured MRI reports of the shoulder can reduce radiologist re-consultations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Abbreviations

CI 95%:

Confidence interval

MSK:

Musculoskeletal

NRs:

Narrative free text reports

SRs:

Structured reports

std:

Standard deviation

References

  1. Sinitsyn VE, Komarova MA, Mershina EA (2014) Radiology report: past, present and future. Vestn Rentgenol Radiol 3:35–40

    Google Scholar 

  2. Sierra AE, Bisesi MA, Rosenbaum TL, Potchen EJ (1992) Readability of the radiologic report. Investig Radiol 27:236–239

    Article  CAS  Google Scholar 

  3. Soekhoe JK, Groenen MJ, van Ginneken AM et al (2007) Computerized endoscopic reporting is no more time-consuming than reporting with conventional methods. Eur J Intern Med 18:321–325

    Article  PubMed  Google Scholar 

  4. Douglas PS, Hendel RC, Cummings JE et al (2009) ACCF/ACR/AHA/ASE/ASNC/HRS/NASCI/RSNA/SAIP/SCAI/SCCT/SCMR 2008 Health policy statement on structured reporting in cardiovascular imaging. J Am Coll Cardiol 53:76–90

    Article  PubMed  Google Scholar 

  5. Langlotz CP (2009) Structured radiology reporting: are we there yet? Radiology 253:23–25

    Article  PubMed  Google Scholar 

  6. Sobel JL, Pearson ML, Gross K et al (1996) Information content and clarity of radiologists' reports for chest radiography. Acad Radiol 3:709–717

    Article  CAS  PubMed  Google Scholar 

  7. Khorasani R, Bates DW, Teeger S, Rothschild JM, Adams DF, Seltzer SE (2003) Is terminology used effectively to convey diagnostic certainty in radiology reports? Acad Radiol 10:685–688

    Article  PubMed  Google Scholar 

  8. (RSNA) RSoNA RadLex. http://www.rsna.org/RadLex.aspx. Accessed Aug 2016

  9. Naik SS, Hanbidge A, Wilson SR (2001) Radiology reports: examining radiologist and clinician preferences regarding style and content. AJR Am J Roentgenol 176:591–598

    Article  CAS  PubMed  Google Scholar 

  10. Bosmans JM, Weyler JJ, De Schepper AM, Parizel PM (2011) The radiology report as seen by radiologists and referring clinicians: results of the COVER and ROVER surveys. Radiology 259:184–195

    Article  PubMed  Google Scholar 

  11. Bosmans JM, Peremans L, Menni M, De Schepper AM, Duyck PO, Parizel PM (2012) Structured reporting: if, why, when, how-and at what expense? Results of a focus group meeting of radiology professionals from eight countries. Insights Imaging 3:295–302

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Johnson AJ, Chen MY, Swan JS, Applegate KE, Littenberg B (2009) Cohort study of structured reporting compared with conventional dictation. Radiology 253:74–80

    Article  PubMed  Google Scholar 

  13. Brook OR, Brook A, Vollmer CM, Kent TS, Sanchez N, Pedrosa I (2015) Structured reporting of multiphasic CT for pancreatic cancer: potential effect on staging and surgical planning. Radiology 274:464–472

    Article  PubMed  Google Scholar 

  14. Schwartz LH, Panicek DM, Berk AR, Li Y, Hricak H (2011) Improving communication of diagnostic radiology findings through structured reporting. Radiology 260:174–181

    Article  PubMed  PubMed Central  Google Scholar 

  15. Larson DB, Towbin AJ, Pryor RM, Donnelly LF (2013) Improving consistency in radiology reporting through the use of department-wide standardized structured reporting. Radiology 267:240–250

    Article  PubMed  Google Scholar 

  16. Bosmans JM, Neri E, Ratib O, Kahn CE Jr (2015) Structured reporting: a fusion reactor hungry for fuel. Insights Imaging 6:129–132

    Article  PubMed  Google Scholar 

  17. Browning T (2014) The process of structured reporting: adding value and quality. In: Chhabra A, Soldatos T (eds) Musculoskeletal MRI structured evaluation: how to practically fill the reporting checklist. Wolters Kluwer, Philadelphia

    Google Scholar 

  18. Ellman H (1990) Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res 64–74

  19. Zanetti M, Gerber C, Hodler J (1998) Quantitative assessment of the muscles of the rotator cuff with magnetic resonance imaging. Investig Radiol 33:163–170

    Article  CAS  Google Scholar 

  20. Thomazeau H, Rolland Y, Lucas C, Duval JM, Langlais F (1996) Atrophy of the supraspinatus belly. Assessment by MRI in 55 patients with rotator cuff pathology. Acta Orthop Scand 67:264–268

    Article  CAS  PubMed  Google Scholar 

  21. Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 78–83

  22. Bateman J (1972) The shoulder and neck. In: Saunders W (ed) The shoulder and neck. Saunders, Philadelphia, pp 213–235

    Google Scholar 

  23. Davidson J, Burkhart SS (2010) The geometric classification of rotator cuff tears: a system linking tear pattern to treatment and prognosis. Arthroscopy 26:417–424

    Article  PubMed  Google Scholar 

  24. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  CAS  PubMed  Google Scholar 

  25. Plumb AA, Grieve FM, Khan SH (2009) Survey of hospital clinicians' preferences regarding the format of radiology reports. Clin Radiol 64:386–394; 395–386

  26. Grieve FM, Plumb AA, Khan SH (2010) Radiology reporting: a general practitioner's perspective. Br J Radiol 83:17–22

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Weiss DL, Langlotz CP (2008) Structured reporting: patient care enhancement or productivity nightmare? Radiology 249:739–747

    Article  PubMed  Google Scholar 

  28. Marcovici PA, Taylor GA (2014) Journal club: structured radiology reports are more complete and more effective than unstructured reports. AJR Am J Roentgenol 203:1265–1271

    Article  PubMed  Google Scholar 

  29. Kahn CE Jr, Langlotz CP, Burnside ES et al (2009) Toward best practices in radiology reporting. Radiology 252:852–856

    Article  PubMed  Google Scholar 

  30. Sistrom CL, Honeyman-Buck J (2005) Free text versus structured format: information transfer efficiency of radiology reports. AJR Am J Roentgenol 185:804–812

    Article  PubMed  Google Scholar 

  31. Hawkins CM, Hall S, Hardin J, Salisbury S, Towbin AJ (2012) Prepopulated radiology report templates: a prospective analysis of error rate and turnaround time. J Digit Imaging 25:504–511

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Hawkins CM, Hall S, Zhang B, Towbin AJ (2014) Creation and implementation of department-wide structured reports: an analysis of the impact on error rate in radiology reports. J Digit Imaging 27:581–587

    Article  PubMed  PubMed Central  Google Scholar 

  33. Hassanpour S, Langlotz CP (2015) Unsupervised topic modeling in a large free text radiology report repository. J Digit Imaging. doi:10.1007/s10278-015-9823-3

    PubMed Central  Google Scholar 

  34. Powell DK, Silberzweig JE (2015) State of structured reporting in radiology, a survey. Acad Radiol 22:226–233

    Article  PubMed  Google Scholar 

  35. Lin E, Powell DK, Kagetsu NJ (2014) Efficacy of a checklist-style structured radiology reporting template in reducing resident misses on cervical spine computed tomography examinations. J Digit Imaging 27:588–593

    Article  PubMed  PubMed Central  Google Scholar 

  36. Johnson AJ (2012) All structured reporting systems are not created equal. Radiology 262:726, author reply 726-727

  37. (RSNA) RSoNA RadReport. http://www.radreport.org. Accessed Aug 2016

  38. D’Orsi CJSE, Mendelson EB, Morris EA et al (2013) ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. American College of Radiology, Reston

    Google Scholar 

  39. American College of Radiology. Liver Imaging Reporting and Data System version 2014. http://www.acr.org/Quality-Safety/Resources/LIRADS. Accessed Aug 2016

  40. Weinreb JC, Barentsz JO, Choyke PL et al (2016) PI-RADS Prostate Imaging - Reporting and Data System: 2015, version 2. Eur Urol 69:16–40

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

    Authors and Affiliations

    1. Department of Clinical Radiology, Ludwig-Maximilians-University (LMU), Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany

      Sebastian Gassenmaier, Marco Armbruster, Wieland H. Sommer & Nora N. Sommer

    2. Department of Knee, Hip and Shoulder Surgery, Schön Klinik München Harlaching, Munich, Germany

      Florian Haasters

    3. Department of General, Trauma and Reconstructive Surgery, Ludwig-Maximilians-University (LMU), Campus Innenstadt, Munich, Germany

      Florian Haasters & Tobias Helfen

    4. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany

      Thomas Henzler

    5. Ambulatory Health Care Center Radiology & Nuclear Medicine, Fürth, Germany

      Sedat Alibek

    6. Department of Diagnostic Radiology, Friedrich-Alexander University, Erlangen-Nuremberg, Germany

      Sedat Alibek

    7. Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany

      Dominik Pförringer

    Authors
    1. Sebastian Gassenmaier
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Marco Armbruster
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Florian Haasters
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Tobias Helfen
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Thomas Henzler
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Sedat Alibek
      View author publications

      You can also search for this author in PubMed Google Scholar

    7. Dominik Pförringer
      View author publications

      You can also search for this author in PubMed Google Scholar

    8. Wieland H. Sommer
      View author publications

      You can also search for this author in PubMed Google Scholar

    9. Nora N. Sommer
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Sebastian Gassenmaier.

    Ethics declarations

    Guarantor

    The scientific guarantor of this publication is Professor Wieland H. Sommer.

    Conflict of interest

    The authors of this manuscript declare relationships with the following companies: QMedify GmbH. Wieland H. Sommer and Marco Armbruster are co-founders of the website www.smart-radiology.com (by Smart Reporting GmbH), an online platform for structured reporting.

    Funding

    The authors state that this work has not received any funding.

    Statistics and biometry

    One of the authors has significant statistical expertise.

    No complex statistical methods were necessary for this paper.

    Informed consent

    Written informed consent was waived by the institutional review board.

    Ethical approval

    Institutional review board approval was obtained.

    Methodology

    • retrospective

    • diagnostic study

    • performed at one institution

    Additional information

    Sebastian Gassenmaier and Marco Armbruster contributed equally to this work.

    Electronic supplementary material

    Below is the link to the electronic supplementary material.

    ESM 1

    Example of a structured report. The figure shows an example of a structured report used in our study. The report was translated from German and had to be edited due to language reasons and with regard to content for the protection of the patient’s anonymity. (DOC 31 kb)

    ESM 2

    Corresponding narrative free text report to ESM 1. The figure shows the corresponding non-structured narrative free text report used in our study. The report was translated from German and had to be edited due to language reasons and with regard to content for the protection of the patient’s anonymity. (DOC 24 kb)

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Gassenmaier, S., Armbruster, M., Haasters, F. et al. Structured reporting of MRI of the shoulder – improvement of report quality?. Eur Radiol 27, 4110–4119 (2017). https://doi.org/10.1007/s00330-017-4778-z

    Download citation

    • Received:

    • Revised:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s00330-017-4778-z

    Keywords

    Search

    Navigation