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Automated Radiology-Operative Note Communication Tool; Closing the Loop in Musculoskeletal Imaging

Rationale and Objectives

Correlation of imaging studies and reference standard outcomes is a significant challenge in radiology. This study evaluates the effectiveness of a new communication tool by assessing the ability of this system to correctly match the imaging studies to arthroscopy reports and qualitatively assessing radiologist behavior before and after the implementation of this system.

Materials and Methods

Using a commercially available communication or educational tool and applying a novel matching rule algorithm, radiology and arthroscopy reports were matched from January 17, 2017 to March 1, 2017 based on anatomy. The interpreting radiologist was presented with email notifications containing the impression of the imaging report and the entire arthroscopy report. Total correlation rate of appropriate report pairings, modality-specific correlation rate, and the anatomy-specific correlation rate were calculated. Radiologists using the system were given a survey.

Results

Overall correlation rate for all musculoskeletal imaging was 83.1% (433 or 508). Low correlation was found in fluoroscopic procedures at 74.4%, and the highest correlation was found with ultrasound at 88.4%. Anatomic location varied from 51.6% for spine to 98.8% for hips and pelvis studies.

Survey results revealed 87.5% of the respondents reporting being either satisfied or very satisfied with the new communication tool. The survey also revealed that some radiologists reviewed more cases than before.

Conclusions

Matching of radiology and arthroscopy reports by anatomy allows for excellent report correlation (83.1%). Automated correlation improves the quality and efficiency of feedback to radiologists, providing important opportunities for learning and improved accuracy.

Introduction

Correlation of imaging findings with histopathology results or operative findings is essential for attaining expertise in radiology . Although correlation to a reference standard has been a hallmark of radiology teaching for years, some areas within radiology are poorly suited for this type of learning . Correlations for musculoskeletal (MSK) imaging, aside from pathology results for bone and soft tissue tumors, can be difficult to perform because the process of obtaining the reference standard, the arthroscopy report, can be arduous and requires dedication of the radiologist to manually correlate the arthroscopy report with the imaging studies . Report correlation can be more difficult when the patient does not undergo surgery for days or weeks, if ever, following the interpretation of the relevant imaging study. Although imaging-arthroscopy correlation conferences and tumor boards are valuable, only a small number of select cases are reviewed, limiting the number of cases discussed for each individual radiologist.

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Methods

Radiology—Operative Report Matching Module Development

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Subjects

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Radiology—Arthroscopy Report Correlation Assessment

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Survey of Radiologist Behavior

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Statistics

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Results

Radiology—Arthroscopy Report Correlation Assessment

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TABLE 1

Correlative Results of the Radiology-Operative Note Module Separated by Specific Modality

Body Part Total ( n ) % Correlative Spine 95 51.6 Elbow, forearm, wrist, and hand 75 86.7 Shoulder and humerus 82 87.8 Knee and femur 108 93.4 Ankle or foot and lower extremity 79 93.7 Pelvis and hips 82 98.8

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TABLE 2

Correlative Results of the Radiology—Operative Note Module Separated by Specific Anatomic Location

Body Part Total ( n ) % Correlative Fluoroscopy 35 71.4 CT 177 79.7 Ultrasound 43 88.4 MRI 266 86.1

CT, computed tomography; MRI, magnetic resonance imaging.

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Survey Results

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Figure 1, According to the survey given, some radiologists reviewed more cases after implementation of the OpNotes program.

Figure 2, Before emailed OpNotes, only 31% of respondents reported reviewing all types of cases.

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Figure 3, After emailed OpNotes, 63% of respondents reported reviewing all types of cases.

Figure 4, Survey results revealed the majority of radiologists using OpNotes (13 of 16 or 81.1%) described the email feedback system as easy or very easy.

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TABLE 3

Level of Satisfaction of Follow-up Before and After the OpNote System

Manual Follow-up Automated OpNote Follow-up Very unsatisfied 13% (2/16) 6% (1/16) Unsatisfied 25% (4/16) 6% (1/16) Indifferent 44% (7/16) 0% (0/16) Satisfied 13% (2/16) 50% (8/16) Very satisfied 6% (1/16) 38% (6/16)

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Discussion

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Conclusion/Summary

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Supplementary Data

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Appendix S1

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References

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