Structured Reporting versus Free-Text Reporting for Appendiceal Computed Tomography in Adolescents and Young Adults: Preference Survey of 594 Referring Physicians, Surgeons, and Radiologists from 20 Hospitals

Abstract

Objective: To survey care providers' preference between structured reporting (SR) and free-text reporting (FTR) for appendiceal computed tomography (CT) in adolescents and young adults.

Materials and methods: An ethical committee approved this prospective study. The requirement for participant consent was waived. We distributed the Likert scale-based SR form delivering the likelihood of appendicitis across 20 hospitals through a large clinical trial. In the final phase of the trial, we invited 706 potential care providers to participate in an online survey. The survey questions included usefulness in patient management, communicating the likelihood of appendicitis, convenience, style and format, and overall preference. Logistic regression analysis was performed for the overall preference. Three months after the completion of the trial, we checked if the use of the SR was sustained.

Results: Responses were analyzed from 594 participants (175 attendings and 419 trainees; 225 radiologists, 207 emergency physicians, and 162 surgeons). For each question, 47.3-64.8% of the participants preferred SR, 13.1-32.7% preferred FTR, and the remaining had no preference. The overall preference varied considerably across the hospitals, but slightly across the departments or job positions. The overall preference for SR over FTR was significantly associated with attendings, SR experience for appendiceal CT, hospitals with small appendectomy volume, and hospitals enrolling more patients in the trial. Five hospitals continued using the SR in usual care after the trial.

Conclusion: Overall, the care providers preferred SR to FTR. Further investigation into the sustained use of the SR is needed.

Keywords: Appendicitis; CT; Questionnaires; Radiology information system; Structured reporting; Survey.

Fig. 1. Flow diagram for selection of study participants.

Fig. 2. Stacked bar graph showing survey responses for questions Q3–Q7 regarding preference between SR and FTR according to participants' departments and job positions.

Length of each stack indicates percentage of participants in that category with respect to entire study group. Each number is number of participants included in stack. FTR = free-text reporting, SR = structured reporting

Fig. 3. Stacked bar graph showing per-hospital survey responses for overall preference (Q7) between SR and FTR.

Length of each stack indicates percentage of participants in particular hospital with respect to entire study population. Each number is number of participants included in stack. As of May 2017, five hospitals (denoted by ^*) were completely using SR, eight hospitals (denoted by ^†) were partially using SR, and seven hospitals (denoted by ^‡) were rarely using SR in usual care.