Contextualized vs. structured reports—which templates are better?
Many providers prefer contextualized reports over standard structured reports, but there is a time and a place for such templates, new survey results suggest.
The results, published in Current Problems in Diagnostic Radiology, indicate that providers find contextualized reports (CR) easier to read than structured reports (SR), with over half of the respondents favoring CR.
CRs differ from SRs in that they focus on specific clinical indications, rather than a basic standardized checklist of anatomical regions that does not always address a particular concern.
“CR is a type of SR which is tailored to a narrow clinical indication by including pertinent positive and negative findings for that specific clinical entity,” corresponding author Ashishkumar K. Parikh MD, with the department of radiology at Children's Healthcare of Atlanta, and colleagues explained. “For example, a radiologist may use the SR maxillofacial CT template for a patient with orbital cellulitis, which may include assessments of anatomical structures in the field of view that are not related to orbital cellulitis and lack specific information regarding superior ophthalmic vein or cavernous sinus involvement.”
Although there are currently numerous disease processes in which CR is already being utilized, there are many more SR templates in use today.
To better understand provider preference, the group surveyed more than 300 pediatric providers who specialized in either some form of neurology or gastroenterology. The neuroimaging group looked at CR and SR reports of an orbital CT for orbital cellulitis and a head CT for stroke, while the GI group was presented with example reports of an abdominal CT for appendicitis and an MRI enterography for Crohn's disease.
More than half of all the respondents (56%) indicated favor for CR, while 29% preferred SR. Nearly 60% noted that CRs were easier to interpret, but the GI group tended to favor them more, possibly due to the more common indications within that specialty (i.e., appendicitis).
Although the groups did tend to favor CR, the templates might not be feasible or appropriate for widespread adoption. Having a template that highlights positive and negative findings for a specific disease is beneficial, but not in all clinical contexts, the authors noted.
“We understand that not all examinations are ordered with one disease process in mind. Often, the referring clinician wants to address a multitude of possibilities for a patient's symptomatology, which sometimes can vary from something acute to a chronic or life-threatening condition,” the group wrote. “In these cases, structured reporting would still play a primary role in radiology reporting.”
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.