Felicity Jane Pool MBCHB, FRANZC, Presenter: Spouse, counsel Asia Pacific, Covidien AG

Stacy Kellan Goergen MBBS, Abstract Co-Author: Nothing to Disclose

1.To identify evidence relating style and content of the written radiology report to measures of quality. 2.To determine significant evidence gaps that could be filled by further research. 

Two articles relating to written radiology report quality were used as sources of MESH headings for a search performed in MEDLINE in September 2008. A priori criteria for inclusion and exclusion were applied. Citation reference lists were searched for relevant articles. Websites of international radiology professional organisations were searched for guidelines and standards relating to the written report. Guidelines and standards were appraised using the AGREE tool. Efficacy studies proved to be rare and therefore application of conventional appraisal methods was not possible in most cases, so an evidence table and summary were produced.

Four guideline/standards documents were identified. Development methodology and use of evidence and /or evidence appraisal to support recommendations were not well documented in 3 of these. 23 studies were retrieved in total, excluding narrative literature reviews and editorials. There were no randomised controlled trials. No validated metrics for assessment of report quality were found. 3 studies measured aspects of report quality before and after various interventions. 2 studies evaluated referrer understanding of terminology used by radiologists to describe uncertainty. 9 studies surveyed attitudes of referrers and / or radiologists to radiology reports. 11 others involved report audits and analyses.  3 studies combined 2 or more of these designs.  Survey respondents placed high importance on accuracy and clarity . Surveys assessing report format found strong support for structured and itemised reports. Audits of actual reports demonstrated significant omissions in terms of aspects of pre-determined critical content.

There is little evidence about which elements of report form and content contribute to subjective impressions of clarity and quality, or about how this impacts on clinical decision making.  Efficacy studies about interventions to improve report quality are lacking.  Existing guidelines/standards are not explicitly linked to research evidence.

There is a lack of quality research about how style and content determine report clarity and quality, even though these can have a major impact on clinical decision making.

Pool, F, Goergen, S, What Are the Contributors to Quality in a Written Radiology Report?  A Literature Review.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8003247.html