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Evidence-Based Reporting: A Method to Optimize Prostate MRI Communications With Referring Physicians
Michael J Magnetta1, Ashley L Donovan2, Bruce L Jacobs3
11 Department of Diagnostic Radiology, University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh, PA 15213.
Objective:
The purpose of this study was to develop an evidence-based method to optimize prostate MRI reports that would improve communication between urologists and radiologists.
Materials And Methods:
This quality improvement initiative was approved by the institutional Quality Improvement Review Committee. A structured report was developed containing essential components defined by local practice norms and Prostate Imaging Reporting and Data System (PI-RADS) lexicon version 2. Two hundred preintervention and 100 postintervention reports were retrospectively reviewed for essential components. Additionally, a sample of 40 reports generated before the intervention and 40 reports generated after the intervention that made use of the structured report were evaluated by a urologist and were scored on a 5-point scale for consistency, completeness, conciseness, clarity, likelihood to contact radiologist, and clinical impact. Variables were compared with ANOVA, chi-square, or Fisher exact test.
Results:
Essential components of the report were utilization of the PI-RADSv2 lexicon, findings listed by lesion, reporting of pertinent positive and negative findings (extraprostatic extension, seminal vesicle, and neurovascular bundle invasion), and low word count. In postintervention reports, all essential measures were statistically improved except for mean report word count. The urologist indicated statistically improved consistency (before intervention, 2.7; after intervention, 3.5; χ2 < 0.001), completeness (before intervention, 2.8; after intervention, 3.3; χ2 < 0.001), clarity (before intervention, 2.9; after intervention, 3.3; χ2 < 0.05), and clinical impact (before intervention, 2.8; after intervention, 3.8; χ2 < 0.001) of the report with reduced perceived need to contact (before intervention, 3.2; after intervention, 2.1; χ2 < 0.001) the interpreting radiologist for explanation.
Conclusion:
The structured prostate MRI report resulted in improved communication with referring urologists as indicated by the increased perceived clinical impact of the report.
Insights
A structured prostate MRI report improved communication between urologists and radiologists. The new reporting method enhanced consistency, completeness, and clarity, leading to greater clinical impact.
Area of Science:
- Radiology
- Urology
- Medical Informatics
Background:
- Prostate MRI reports are crucial for diagnosing and managing prostate cancer.
- Effective communication between radiologists and urologists is essential for optimal patient care.
- Current reporting methods may lack standardization, leading to potential communication gaps.
Purpose of the Study:
- To develop and evaluate an evidence-based, structured reporting system for prostate MRI.
- To enhance communication and clinical decision-making between urologists and radiologists.
- To improve the consistency, completeness, and clarity of prostate MRI reports.
Main Methods:
- A quality improvement initiative implemented a structured prostate MRI report template.
- The template incorporated the Prostate Imaging Reporting and Data System (PI-RADS) lexicon version 2 and local practice norms.
- Pre- and post-intervention reports were retrospectively analyzed for essential components, and urologist feedback was collected on report quality and clinical utility.
Main Results:
- Post-intervention reports demonstrated statistically significant improvements in consistency, completeness, and clarity compared to pre-intervention reports.
- Urologists reported a reduced need to contact radiologists for clarification after the structured report implementation.
- The perceived clinical impact of the reports significantly increased following the intervention.
Conclusions:
- A structured prostate MRI reporting system effectively enhances communication between urologists and radiologists.
- The structured report improves the quality and clinical utility of prostate MRI findings.
- This evidence-based method optimizes prostate MRI reporting for better patient management.
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