Variation in the level of detail in pediatric voiding cystourethrogram reports

Area of Science:

• Pediatric Radiology
• Urology
• Medical Imaging Reporting Standards

Background:

• Voiding cystourethrogram (VCUG) is vital for assessing urinary tract function and anatomy.
• Standardized reporting guidelines for VCUG findings are currently lacking.
• Variability in VCUG report completeness can impact clinical decision-making.

Purpose of the Study:

• To evaluate the variability in completeness of VCUG reports.
• To determine if reports from pediatric facilities and radiologists are more comprehensive.
• To identify factors influencing the quality of VCUG reporting.

Main Methods:

• Analysis of 602 VCUG reports from the RIVUR trial across 90 institutions.
• Development and application of a 23-item checklist to assess technical, anatomic, and functional information.
• Multivariate regression analysis to identify predictors of report completeness, including radiologist and facility type.

Main Results:

• VCUG reports averaged only 48% completeness, with significant variation by facility type (p < 0.0001).
• Reports from non-pediatric hospitals and outpatient facilities were less complete than those from freestanding pediatric hospitals.
• Reports read by non-pediatric radiologists were less complete than those read by pediatric radiologists (p < 0.01).

Conclusions:

• Significant underreporting of critical VCUG findings exists in routine clinical practice.
• While pediatric-focused settings show slightly better reporting, substantial room for improvement remains across all types of facilities.
• Standardization of VCUG reporting is necessary to ensure comprehensive documentation of urinary tract evaluations.