Structured reporting has the potential to reduce reporting times of dual-energy x-ray absorptiometry exams

BMC Musculoskelet Disord. 2020 Apr 16;21(1):248. doi: 10.1186/s12891-020-03200-w.


Background: In recent years, structured reporting has been shown to be beneficial with regard to report completeness and clinical decision-making as compared to free-text reports (FTR). However, the impact of structured reporting on reporting efficiency has not been thoroughly evaluted yet. The aim of this study was to compare reporting times and report quality of structured reports (SR) to conventional free-text reports of dual-energy x-ray absorptiometry exams (DXA).

Methods: FTRs and SRs of DXA were retrospectively generated by 2 radiology residents and 2 final-year medical students. Time was measured from the first view of the exam until the report was saved. A random sample of DXA reports was selected and sent to 2 referring physicians for further evaluation of report quality.

Results: A total of 104 DXA reports (both FTRs and SRs) were generated and 48 randomly selected reports were evaluated by referring physicians. Reporting times were shorter for SRs in both radiology residents and medical students with median reporting times of 2.7 min (residents: 2.7, medical students: 2.7) for SRs and 6.1 min (residents: 5.0, medical students: 7.5) for FTRs. Information extraction was perceived to be significantly easier from SRs vs FTRs (P < 0.001). SRs were rated to answer the clinical question significantly better than FTRs (P < 0.007). Overall report quality was rated significantly higher for SRs compared to FTRs (P < 0.001) with 96% of SRs vs 79% of FTRs receiving high or very high-quality ratings. All readers except for one resident preferred structured reporting over free-text reporting and both referring clinicians preferred SRs over FTRs for DXA.

Conclusions: Template-based structured reporting of DXA might lead to shorter reporting times and increased report quality.

Keywords: Bone density; Clinical decision-making; Decision trees; Quality improvement; X-rays.

MeSH terms

  • Absorptiometry, Photon / methods*
  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Decision-Making
  • Female
  • Humans
  • Information Storage and Retrieval
  • Male
  • Medical Records*
  • Middle Aged
  • Osteoporosis / diagnostic imaging*
  • Radiologists
  • Research Design*
  • Research Report*
  • Retrospective Studies
  • Software
  • Students, Medical
  • Surveys and Questionnaires