Comparative analysis and assessment of radiological investigation reports for abdomen and pelvic computed tomography scans

Introduction

In recent years, diagnostic imaging investigations have advanced and been amplified. It has spurred the necessity for thorough, accurate reporting. Well-crafted reports reflect the judgement of the radiologists serving as a standard of reference for radiology trainees, thus acting as a channel of communication with physicians, guiding the decision-making, management, and long-term follow-up. Also, it works as a legal document when malpractice is asserted.¹

The reporting services provided by many radio-diagnostic imaging facilities of large hospitals have progressed so much over the years that the facilities can provide quick support to the attending residents in order to produce reports promptly. Contrarily, this rapidity of report generation has also increased the likelihood of variations between the preliminary and final attending reports, as reflected in numerous studies; however, there is a dearth of research about it, specific to the radiology department and its practices.^2–5 Radiology residents at healthcare facilities routinely provide preliminary imaging study interpretations within hours, and their skill and accuracy are vital to the treatment of patients.⁶ Therefore, all radiologists must seek to acquire, improve, and update the skills needed to generate optimal reports from the very outset of their training. Towards this goal, a radiologist’s formative training or residency years should incorporate a method to generate an adequate report.⁷

Quantifying the frequency and types of variations in the standard, abnormal, additional findings and interpretations between the junior residents’ and the radiologists practising in the same hospital system can be a valuable tool for directing general education and systematic quality improvement. This topic has been the subject of numerous past research but was often limited to particular or short periods.^2–5 Thus, an attempt has been made in this study to examine provisional and final computed tomography (CT) scan reports of the abdo-pelvic region prepared by junior residents in radiology and radiologists to prepare a study protocol.⁸ The reports have been collected and analysed for a comprehensive study. Findings and variances have been assessed in provisional and final reports based on the examinations performed and their interpretations.⁹

To identify appropriate indicators of resident performance effectiveness and competence that are equally consistent with patient care, reading the provisional and finalized report findings can serve as a potential criterion for finding better interpretation possibilities and eliminating contradictions. Additionally, it can serve as a valuable source of research to demonstrate and strengthen the fact that radiology residents’ reporting is genuinely on par with the radiologists’, contributing to residents’ credibility and elevating their overall self-confidence in reporting.

Protocol

Methods

Initially, the reports will be reviewed for findings such as under-reading, fulfilment of search, flawed reasoning, irregularities outside the scope of interest, fulfilment of report, neglecting to refer to prior imaging studies, inaccurate or insufficient clinical history, report not reaching referring clinician accurately, flawed measurements and so on during the two-year research period to assess their clinical impact on the hospital system and patient care.

Secondly, the database will encompass a total of 128 abdo-pelvic CT imaging studies that were first evaluated by a junior resident and then reviewed by the radiologist.

Under the supervision of an experienced senior radiologist, a comparison of the preliminary reports by the resident and the final reports by the attending radiologist will then be conducted. Finally, patterns of “similar,” “additional,” and “not carried forward” findings will be noted and tabulations, graphs will be used to quantify the degree and frequency of variation between the two report interpretations. Utilizing a standardized proforma considering the age and sex of the patient, a thorough investigation of the radiological reports for abdominal and pelvic CT scans will be done.¹¹ This method of approach seeks to help document and evaluate the factors contributing to the variations between preliminary and final reports.

Discussion

Radiology reports serve an essential role in medical diagnosis and treatment; therefore, the consistency and quality of these reports are vital in guiding clinical decision-making and providing optimal patient care. The variation rates in radiological reports have been the subject of numerous studies, with various degrees of success. According to a study by Ruutiainen et al. (2011), there were differences in the rates of key findings in reports depending on the residents themselves, the modalities they used, and their training levels.⁴ Mellnick et al. (2016), on the other hand, discovered a reasonably low incidence of variance for radiology residents interpreting examinations after hours, with a very low rate of critical variations.¹² According to a 2016 study by Harari et al., 31% of reports were confirmed as unaltered, with no appreciable differences between junior and senior residents.¹⁰ However, according to an earlier study by Cooper et al. (2008), a slight increase in accuracy was noticed as the resident year progressed.¹³ However, Dinh et al. (2020) suggested that despite advancements in technology and training, variances can still happen.¹⁴ In relation to our research, these studies offer insightful information about the variables, such as resident training level, modality, and reporting quality, that affect variability in radiology reports. They highlight the significance of quality assurance processes, training opportunities, and adopting benchmark criteria for variation rates and response times to ensure high-quality patient care. Despite advancements in technology and training, variations can persist; thus, it is essential to inquire into their potential causes and find efficient strategies to mitigate them, providing patients with the best possible care.¹⁵

Conclusions

In conclusion, reviewing and analyzing the results of abdominopelvic CT scans for patients of different age groups and genders is a viable way to assess the clinical outcomes and can serve as a roadmap for educational and training programs for residents. The results of this study will help emphasize how crucial precise and accurate reporting is in medical practice. Furthermore, this kind of research encourages residents’ confidence in their reporting skills, resulting in high-quality patient care. Overall, this research holds significant implications for improving patient care and the profession of medical imaging.