Andrea Rosskopf MD, Presenter: Nothing to Disclose

Tobias J. Dietrich MD, Abstract Co-Author: Nothing to Disclose

Anna Hirschmann MD, Abstract Co-Author: Nothing to Disclose

Florian M. Buck MD, Abstract Co-Author: Nothing to Disclose

Reto Sutter MD, Abstract Co-Author: Nothing to Disclose

Christian W. A. Pfirrmann MD, MBA, Abstract Co-Author: Advisory Board, Siemens AG Consultant, Medtronic, Inc

To evaluate the quality of reports of knee MR examinations in form, content and diagnosis and to assess the effect of three different quality improvement measures. 

Reports of 500 consecutive knee MR studies (=first round) in our institution were retrospectively assessed by five musculoskeletal radiologists. In summary 15 different criteria were reviewed for formal and content-related quality of reports. Furthermore diagnostic discrepancies were categorized using a five-point scale: I:no deviation; II:undetected finding, clinically irrelevant; III:wrong interpretation of finding, clinically irrelevant; IV:undetected finding, clinically relevant; V:wrong interpretation of finding, clinically relevant. In the second round three different quality improvement measures were applied to a total of 510 consecutive reports: a quiet work environment, double reading and the use of a structured report template. These 510 knee MR reports were assessed using the same criteria as described above.

In the second round reports a statistically significant improvement in 13 out of 15 criteria of form and content was found: orthographic errors improved from 32.4% to 22.0% (P<0.001) of reports and digital speech recognition errors from 8.4% to 7.6% (P=0.660). The rate of missing anatomical structures dropped from 6.3% to 0.4%. Diagnostic discrepancies decreased from 20.6% to 12.9% (P=0.001) with following changes in categorization (first round results in parentheses): I:87.1%(79.2%), II:9.2%(16.8%), III:2.3%(1.0%), IV:1.0%(2.6%), V:0.4%(0.4%). Quality improvement was found in all three measure groups. No statistically significance between the groups was found – except for the orthographic errors (P<0.001), which were most common in the template group.  

Formal deviations were common. Clinically relevant diagnostic errors occurred rarely and were mostly associated with the detection of lesions rather than its interpretation. All three quality improvement measures significantly improved the quality of the knee MR reports, but no measure was clearly superior to the others.

Our results demonstrate that each proposed quality improvement measure leads to a relevant reduction of errors in structure, content and diagnosis in knee MR reports.

Rosskopf, A, Dietrich, T, Hirschmann, A, Buck, F, Sutter, R, Pfirrmann, C, Quality Management in Musculoskeletal Imaging: Form, Content and Diagnosis of Knee MR Reports and Effectiveness of Three Different Quality Improvement Measures  .  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045458.html