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Published on: April 9, 2019
Impact of an Information Technology-Enabled Initiative on the Quality of Prostate Multiparametric MRI Reports
Patricia C Silveira1, Ruth Dunne2, Nisha I Sainani3
1Department of Radiology, Center for Evidence-Based Imaging, Brigham and Women's Hospital, Harvard Medical School, 20 Kent Street, 2nd Floor, Boston, MA 02445.
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 magnetic resonance imaging (mp-MRI) reports.
Materials And Methods:
Institutional Review Board approval was obtained for this Health Insurance Portability and Accountability Act-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 information technology [IT] tools) integrated into the picture archiving and communication system 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 nine 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 < .001) after implementing the IT tools. Although 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 < .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 = .404).
Conclusions:
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.
Insights
Implementing structured reporting templates and computer-aided diagnosis (CAD) tools significantly improved prostate multiparametric MRI (mp-MRI) report quality. This IT intervention enhanced diagnostic accuracy and reporting standards in radiology.
Area of Science:
- Radiology
- Medical Informatics
- Oncology
Background:
- Prostate multiparametric magnetic resonance imaging (mp-MRI) is crucial for diagnosing and staging prostate cancer.
- The quality of mp-MRI reports directly impacts clinical decision-making.
- Current reporting practices can be variable, affecting consistency and accuracy.
Purpose of the Study:
- To evaluate the impact of integrating a structured report template and a computer-aided diagnosis (CAD) tool on the quality of prostate mp-MRI reports.
- To assess whether these information technology (IT) tools enhance the documentation of key imaging variables.
Main Methods:
- A retrospective study analyzed 385 prostate mp-MRI reports before and after the implementation of a structured template and CAD tool.
- An expert panel defined report quality based on nine predefined variables.
- Statistical analyses (chi-square, t-tests) compared report quality between pre- and post-implementation periods.
Main Results:
- The proportion of optimal or satisfactory reports increased significantly from 29.8% to 53.3% after IT tool implementation (P < .001).
- Reports generated using the IT tools showed a marked improvement in quality (29.8% to 65.2%, P < .001).
- Reports not utilizing the IT tools showed no significant change in quality (29.8% to 24.2%, P = .404).
Conclusions:
- The combined use of a structured report template and CAD tool demonstrably improved prostate mp-MRI report quality.
- These IT tools offer a valuable solution for standardizing and enhancing radiological reporting.
- The findings support the adoption of structured reporting and CAD in clinical practice for better diagnostic outcomes.
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