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Comparative Study
. 2018 Jul 3;18(1):20.
doi: 10.1186/s12880-018-0262-8.

Structured reporting of x-rays for atraumatic shoulder pain: advantages over free text?

Franziska Schöppe  1 , Wieland H Sommer  2 , Florian Schmidutz  3   4 , Dominik Pförringer  5 , Marco Armbruster  2 , Karolin J Paprottka  2 , Jessica L V Plum  2 , Bastian O Sabel  2 , Felix G Meinel  6 , Nora N Sommer  2
Affiliations
Comparative Study

Structured reporting of x-rays for atraumatic shoulder pain: advantages over free text?

Franziska Schöppe et al. BMC Med Imaging. .

Abstract

Background: To analyse structured and free text reports of shoulder X-ray examinations evaluating the quality of reports and potential contributions to clinical decision-making.

Methods: We acquired both standard free text and structured reports of 31 patients with a painful shoulder without history of previous trauma who received X-ray exams. A template was created for the structured report based on the template ID 0000154 (Shoulder X-ray) from radreport.org using online software with clickable decision trees with concomitant generation of structured semantic reports. All reports were evaluated regarding overall quality and key features: content, information extraction and clinical relevance.

Results: Two experienced orthopaedic surgeons reviewed and rated structured and free text reports of 31 patients independently. The structured reports achieved significantly higher median ratings in all key features evaluated (P < 0.001), including facilitation of information extraction (P < 0.001) and better contribution to subsequent clinical decision-making (P < 0.001). The overall quality of structured reports was significantly higher than in free text report (P < 0.001).

Conclusions: A comprehensive structured template may be a useful tool to assist in clinical decision-making and is, thus, recommended for the reporting of degenerative changes regarding X-ray examinations of the shoulder.

Keywords: Clinical decision-making; Decision trees; Quality improvement; Shoulder pain; Structured reporting; X-rays.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Ethics Committee of the University Hospital of the Ludwig-Maximilians-University Munich (LMU). Written informed consent was waived by the Ethics Committee as data were de-identified and analysed anonymously.

Consent for publication

Not applicable.

Competing interests

The authors of this manuscript declare relationships with the following companies:

Smart Radiology (a company for structured reporting templates)

  1. WHS, MA (co-founders)

  2. FrS (until Mai 2017: creating and reviewing structured templates, background research)

All other authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Decision tree (extract). Exemplary section of the decision tree for the evaluation of degenerative changes of the glenohumeral joint due to osteoarthritis (slightly modified for illustration purposes)
Fig. 2
Fig. 2
Ratings by report type for selected questionnaire items. a-c show exemplary histograms of the ratings on a 10-point Likert scale (0 = I do not agree, 10 = I agree) for the items on osteoarthritis (a), structure (b) and the report addressing the clinical question (c) for FTR (N = 62 ratings; white bars on the left) and SR (N = 62 ratings; grey bars on the right); D shows the percentage of the ratings of overall quality by each category for FTR and SR
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