Purpose
Structured reporting,
using the National Institute of Neurological Disorders and Stroke Common Data Elements (NINDS CDEs),
is a promising way of assessing patients with traumatic brain injury (TBI).
Contrary to conventional qualitative and free-text reports,
structured reports are characterized by a standardized format,
a consistent itemized organization and most importantly,
use of standard language [1,2,3].
The NINDS CDEs were specifically developed by a consortium of experts in the field of TBI to provide a standard language and to create consistent data collection across TBI trials...
Methods and materials
Study Design:
Imaging data (a total of 50 unreviewed acute non-contrast CT scans from 9 different hospitals),
were retrospectively selected from the CENTER-TBI imaging database.
This database is a dynamic entity into which images of neurotrauma patients are continuously uploaded by different European hospitals,
participating in the study.
A standard clinical protocol is used in all hospitals and images are initially reviewed by two non-radiologist raters (L.C.,
NS1 or T.VdV.,
NS2).
The studies are then again reviewed by one of two supervising expert neuroradiologists (G.W.,...
Results
Almost perfect overall agreement was found between the non-radiologist raters and the standard (NS1 and NR1,
κ=0.958,
NS2 and NR1,
κ=0.915; 95%,
see fig.
6).
Similar agreement was found between the non-radiologist raters seperately (NS1 and NS2,
κ=0.958; 95% CI,
see fig.
6).
Agreement for individual TBI pathoanatomic lesion types was good to almost perfect for all lesion types (range from κ=0.638 to κ=1; see fig.
6).
The lowest agreement was found for patients with diffuse axonal injuries and cerebral herniation.
Perfect agreement was found...
Conclusion
In this preliminary study,
we investigated the reliability of trained non-radiologist raters for the evaluation of acute non-contrast CT-scans in patients with TBI,
using a digital structured reporting tool based on the most recent CDE templates.
Our findings indicate that non-radiologist raters,
with a background in neuroscience,
and given adequate training,
can reliably and consistently generate structured reports in patients with TBI.
Caution is,
however,
advised,
and we recommend that a trained (neuro)radiologist,
with many years of experience,
should check the reports.
This result is...
Personal information
Thijs Vande Vyvere,(PhD student);
Department of Radiology,
Neuroradiology Division;
Antwerp University Hospital and University of Antwerp;
icometrix;
[email protected]
References
1. SistromCL,
Langlotz CP.
A framework for improving radiology reporting.J Am Coll Radiol.
2005; 2(2):159–167.
2.
Weiss DL,
Langlotz CP.
Structured reporting: Patient care enhancement or productivity nightmare? Radiology.
2008; 249:739–747.
3.
Bosmans JML,
Peremans L,
Menni M,
et al.
Structured reporting: If,
why,
when,
how—and at what expense? Results of a focus group meeting of radiology professionals from eight countries.Insights Imaging.
2012; 3:295–302.
4.
Haacke EM,
et al.
Common data elements in radiologic imaging of traumatic brain injury.
J Magn Reson Imaging.
2010; 516-543....
