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A modified structured magnetic resonance imaging reporting for anal fistula: a study on practicality, timeliness and
Caiyun Wang1, Yuyu Bi1, Chaoyang Li1
1Xian Hospital of Traditional Chinese Medicine, Zhangjiabao, Xian, China.
Aim:
This study sought to compare modified Structured Reports (mSRs) timeliness with Free-text Reports (FRs) and assess mSRs-related clinical practicality and reliability.
Method:
We included patients who underwent preoperative perianal magnetic resonance imaging (MRI) and anal fistula surgery between January 2022 and May 2023. Two radiologists independently produced narrative reports first, then completed mSRs one month later. Reporting times were compared via paired t-test. Two anorectal surgeons independently assessed clinical satisfaction (clarity, comprehensiveness, surgical guidance value), with mutual blinding to each other's evaluations. Clinical satisfaction was analyzed using paired Wilcoxon test; reliability was evaluated via intraclass correlation coefficient (ICC), and agreement via Bland-Altman analysis.
Results:
Radiologist 1 spent more time on FRs [758.72([Formula: see text])] than mSRs [479.8([Formula: see text]), [Formula: see text]]; Radiologist 2 showed similar trends (FRs: 619.24 ([Formula: see text]) vs. mSRs: 354.80 ([Formula: see text]), [Formula: see text]). Stratified by anal fistula subtype: Simple: Radiologist 1 completed mSRs [370.45([Formula: see text])] 37.6% faster than FRs [613.55([Formula: see text]), [Formula: see text]]; Radiologist 2 saved 41.6% time (mSRs: [Formula: see text] vs. FRs: [Formula: see text] [Formula: see text]). Complex: Radiologist 1 reduced time by 36.1% (mSRs: 510.69 ([Formula: see text]) vs. FRs: 799.67([Formula: see text]), [Formula: see text]); Radiologist 2 saved 43.0% (mSRs: 370.62 ([Formula: see text]) vs. FRs: 649.74 ([Formula: see text])). Junior physicians and associate chief physicians both rated FRs lower than mSRs across clarity, completeness, and degree of surgical guidance (all [Formula: see text]). For mSRs, interrater ICC was 0.644 (clarity), 0.903 (completeness), 0.700 (degree of surgical guidance; all 95% CI reported); Bland-Altman plots showed low score differences.
Conclusion:
A mSR significantly reduces report completion time and improves clinical satisfaction among anorectal surgeons. Moreover, it has the potential to enhance radiodiagnostic operational efficiency and exert a positive impact on surgical planning and postoperative outcomes of anal fistulas.
Insights
Modified Structured Reports (mSRs) significantly reduce reporting time for perianal MRI compared to Free-text Reports (FRs). Surgeons also reported higher satisfaction with mSRs, improving surgical planning for anal fistulas.
Area of Science:
- Radiology
- Colorectal Surgery
- Medical Imaging Analysis
Background:
- Perianal magnetic resonance imaging (MRI) is crucial for anal fistula diagnosis and surgical planning.
- Traditional free-text reports (FRs) can be time-consuming to generate and may lack standardized information.
- Modified structured reports (mSRs) offer a potential solution for improving efficiency and clarity in radiological reporting.
Purpose of the Study:
- To compare the timeliness of modified structured reports (mSRs) against free-text reports (FRs) for perianal MRI.
- To evaluate the clinical practicality and reliability of mSRs from the perspective of anorectal surgeons.
- To assess the impact of mSRs on surgical planning and outcomes for anal fistula patients.
Main Methods:
- A cohort of patients undergoing preoperative perianal MRI for anal fistula surgery was included.
- Two radiologists independently generated FRs and subsequently completed mSRs.
- Reporting times were compared using paired t-tests.
- Anorectal surgeons assessed clinical satisfaction (clarity, comprehensiveness, surgical guidance) with blinded evaluations.
- Reliability was assessed using intraclass correlation coefficient (ICC) and Bland-Altman analysis.
Main Results:
- Both radiologists demonstrated significantly reduced reporting times for mSRs compared to FRs, with time savings ranging from 36.1% to 43.0% depending on fistula complexity and radiologist.
- Surgeons rated mSRs higher than FRs in terms of clarity, completeness, and surgical guidance value (p < 0.05).
- Interrater reliability for mSRs was good to excellent (ICC: 0.644 for clarity, 0.903 for completeness, 0.700 for surgical guidance).
Conclusions:
- Modified structured reports (mSRs) offer a significant reduction in reporting time for perianal MRI.
- mSRs enhance clinical satisfaction among anorectal surgeons, improving surgical guidance and planning.
- The adoption of mSRs has the potential to increase radiodiagnostic efficiency and positively influence surgical outcomes for anal fistula patients.
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