Academic Journal
View in EDS
PDF Full Text
HTML Full Text

Enhancing clinician and patient understanding of radiology reports: a scoping review of international guidelines

Bibliographic Details
Title: Enhancing clinician and patient understanding of radiology reports: a scoping review of international guidelines
Authors: Caitlin I. Farmer, Allison M. Bourne, Denise O’Connor, Jeffrey G. Jarvik, Rachelle Buchbinder
Source: Insights into Imaging, Vol 11, Iss 1, Pp 1-10 (2020)
Publisher Information: SpringerOpen, 2020.
Publication Year: 2020
Collection: LCC:Medical physics. Medical radiology. Nuclear medicine
Subject Terms: Comprehension, Diagnostic imaging, Guidelines as topic, Radiology, Review, Medical physics. Medical radiology. Nuclear medicine, R895-920
More Details: Abstract Imaging reports are the primary method of communicating diagnostic imaging findings between the radiologist and the referring clinician. Guidelines produced by professional bodies provide guidance on content and format of imaging reports, but the extent to which they consider comprehensibility for referring clinicians and their patients is unclear. The objective of this review was to determine the extent to which radiology reporting guidelines consider comprehensibility of imaging reports for referring clinicians and patients. We performed a scoping review of English-language diagnostic imaging reporting guidelines. We searched electronic databases (OVID MEDLINE, Embase) and websites of radiological professional organisations to identify guidelines. The extent to which the guidelines recommended essential report features such as technical information, content, format and language, as well as features to enhance comprehensibility, such as lay language summaries, was recorded. Six guidelines from professional bodies representing radiologists from the USA, Canada, Australia and New Zealand, Hong Kong, the UK and Europe were identified from the search. Inconsistencies exist between guidelines in their recommendations, and they rarely consider that patients may read the report. No guideline made recommendations about the reporting of results considering the clinical context, and none recommended features preferred by patients such as lay language summaries. This review identifies an opportunity for future radiology reporting guidelines to give greater consideration to referring clinician and patient preferences.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1869-4101
Relation: http://link.springer.com/article/10.1186/s13244-020-00864-9; https://doaj.org/toc/1869-4101
DOI: 10.1186/s13244-020-00864-9
Access URL: https://doaj.org/article/a9b29d293bca4809bd8a2dabf5956ffd
Accession Number: edsdoj.9b29d293bca4809bd8a2dabf5956ffd
Database: Directory of Open Access Journals
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
    Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHjPtM4BHU3ZchRwgzYmadcigk49r9CVlbU7V5F6lgH7WwGRANrjkwhTRy2U3okt7izmAAAA4jCB3wYJKoZIhvcNAQcGoIHRMIHOAgEAMIHIBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDCYGkqlKRjRu6fmekQIBEICBmvViGpnBykJ67XpgcSPz2Ws1lH5dqlkDvRBmhEjDYNPkVFPSZyCqb2FqLHgoh4XA8OQsIBzsxKH1dypX75Y4QY_6oC88uxLaTMhyug6b08vpIu6-3JDTDgw_NbNjVrDjM6hfM-a85sRYLCNQQ1vwzsGADPwx9s71vzFsy0UdgxRSf-NG5GfTPujNAjq0W0dOqslAf6dFrJAMUQc=
Text:
  Availability: 1
  Value: <anid>AN0143677006;[b617]05may.20;2020Jun11.02:58;v2.2.500</anid> <title id="AN0143677006-1">Enhancing clinician and patient understanding of radiology reports: a scoping review of international guidelines </title> <p>Imaging reports are the primary method of communicating diagnostic imaging findings between the radiologist and the referring clinician. Guidelines produced by professional bodies provide guidance on content and format of imaging reports, but the extent to which they consider comprehensibility for referring clinicians and their patients is unclear. The objective of this review was to determine the extent to which radiology reporting guidelines consider comprehensibility of imaging reports for referring clinicians and patients. We performed a scoping review of English-language diagnostic imaging reporting guidelines. We searched electronic databases (OVID MEDLINE, Embase) and websites of radiological professional organisations to identify guidelines. The extent to which the guidelines recommended essential report features such as technical information, content, format and language, as well as features to enhance comprehensibility, such as lay language summaries, was recorded. Six guidelines from professional bodies representing radiologists from the USA, Canada, Australia and New Zealand, Hong Kong, the UK and Europe were identified from the search. Inconsistencies exist between guidelines in their recommendations, and they rarely consider that patients may read the report. No guideline made recommendations about the reporting of results considering the clinical context, and none recommended features preferred by patients such as lay language summaries. This review identifies an opportunity for future radiology reporting guidelines to give greater consideration to referring clinician and patient preferences.</p> <p>Keywords: Comprehension; Diagnostic imaging; Guidelines as topic; Radiology; Review</p> <hd id="AN0143677006-2">Key points</hd> <p></p> <ulist> <item> Radiology reporting guidelines produced by international radiology professional bodies are focused on technical detail and structure of the report.</item> <p></p> <item> Radiology reports are increasingly accessed by a wide range of healthcare clinicians with varying levels of expertise, as well as patients themselves, and it is important they understand a report as it was intended.</item> <p></p> <item> International guidelines rarely consider many of the preferences for radiology reporting expressed by referring clinicians and patients which may lead to confusion and anxiety.</item> </ulist> <hd id="AN0143677006-3">Introduction</hd> <p>Outside of hospital settings, where co-located clinicians and radiologists are able to more easily communicate, diagnostic imaging requests and reports are the primary means by which referring clinicians and the radiologists who report imaging findings communicate with each other [[<reflink idref="bib1" id="ref1">1</reflink>]]. The report may also be read by a range of other healthcare professionals with varying levels of experience and knowledge. It is therefore imperative that both the requests and reports are understood in the way they are intended in order to inform appropriate clinical decisions.</p> <p>It is widely accepted that diagnostic imaging reports must provide an accurate and detailed interpretation of the imaging findings. Less clear is exactly how that message should be communicated. Radiology reports vary widely in terms of phrasing, length and clarity [[<reflink idref="bib2" id="ref2">2</reflink>]], and there is growing evidence that referring clinicians and patients interpret ambiguous phrasing in radiology reports with more concern than radiologists, increasing patient anxiety and rates of follow-up testing [[<reflink idref="bib3" id="ref3">3</reflink>]]. In a study of 15 different phrases commonly used to convey the level of diagnostic certainty, radiologists and referring clinicians only agreed on one phrase ('diagnostic of') [[<reflink idref="bib4" id="ref4">4</reflink>]]. Along with diagnostic ambiguity, the use of more medical or precise terminology to describe a condition has been shown to lead to higher levels of patient anxiety, as well as perceptions of increased severity of the condition, and patient preference for more invasive treatments [[<reflink idref="bib5" id="ref5">5</reflink>]].</p> <p>Professional member associations such as the American College of Radiology (ACR) [[<reflink idref="bib6" id="ref6">6</reflink>]] and the Australian and New Zealand College of Radiologists (RANZCR) [[<reflink idref="bib7" id="ref7">7</reflink>]] have guidelines regarding the content and structure of radiology reports. These guidelines aim to improve the quality and utility of imaging reports. The objective of this review was to determine the extent to which radiology reporting guidelines consider the preferences of the referring clinician and patient particularly with regard to comprehensibility of imaging reports.</p> <hd id="AN0143677006-4">Methods</hd> <p></p> <hd id="AN0143677006-5">Design</hd> <p>We conducted a scoping review using the methodology described by Arksey and O'Malley [[<reflink idref="bib8" id="ref8">8</reflink>]] and Levac et al. [[<reflink idref="bib9" id="ref9">9</reflink>]]. We reported our search and selection results according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR) [[<reflink idref="bib10" id="ref10">10</reflink>]].</p> <hd id="AN0143677006-6">Selection criteria</hd> <p>We included all guidelines for communication of diagnostic imaging results created and published by a radiology professional body or a national member organisation and available in English. Guidelines in other languages without an official English translation were excluded as adequate translation services were not available; however, Google translate was used to identify potentially relevant publications in other languages. Publications from organisations other than radiology professional bodies, experimental studies, surveys, opinion pieces, editorials, guidelines regarding interventional radiology and guidelines on radiology research were also excluded as were research papers used to inform guidelines and condition-specific guidelines, such as the Thyroid Imaging Reporting and Data System (TI-RADS) for reporting incidental thyroid nodules [[<reflink idref="bib11" id="ref11">11</reflink>]].</p> <hd id="AN0143677006-7">Search methods for identifying guidelines</hd> <p>We searched all 57 available websites of national member radiology societies associated with the International Society of Radiology (<ulink href="http://www.isradiology.org/2017/isr/index.php">http://www.isradiology.org/2017/isr/index.php</ulink>). We also searched OVID MEDLINE and Embase from inception to 26 March 2019. The search strategy was developed in conjunction with an experienced librarian, and for MEDLINE, it was the following:</p> <p></p> <ulist> <item> ((imag* or radiolog*) adj5 (result* or report* or record* or outcome*)).ti.</item> <p></p> <item> (Recommendation* or practice* or guideline* or guidance or standard* or protocol* or instruction* or information or method or convention).ti.</item> <p></p> </ulist> <p>• 1 and 2</p> <p></p> <ulist> <item> Exp animals/ not humans.sh.</item> <p></p> </ulist> <p>• 3 not 4</p> <p>The search strategy for Embase was similar except that line 4 was replaced with (exp animal/ or nonhuman/) not exp human/.</p> <p>The reference lists of included guidelines and relevant articles were reviewed to identify additional guidelines. Only the most recent version of guidelines from each organisation was included.</p> <hd id="AN0143677006-8">Screening and selection</hd> <p>Two review authors (C.F. and A.B.) independently screened the titles and abstracts identified by the search. Full-text reports of potentially eligible guidelines were obtained and screened independently by two review authors (C.F. and A.B.). Discrepancies were to be resolved by discussion, but there was no discordance between reviewers. A PRISMA flow chart was developed to summarise the search and selection process (Fig. 1).</p> <p>Graph: Fig. 1 PRISMA diagram</p> <hd id="AN0143677006-9">Data extraction and synthesis</hd> <p>A recent evidence-based guideline for the written radiology report that included a literature review, multi-disciplinary panel and public consultation [[<reflink idref="bib12" id="ref12">12</reflink>]] and which informed the RANZCR guidelines [[<reflink idref="bib12" id="ref13">12</reflink>]] was used as a template to extract recommendations for each guideline. This template can be grouped into four broad areas: technical information (patient demographics, comparison with prior studies, technique, procedural information, report status and examination quality), content (clinical information, relevant or abnormal findings, normal findings, addressing the clinical question, differential diagnosis, conclusion, recommendations for further testing or treatment and any discrepancy documentation), format (length, structured reporting, terminology for referring clinicians and patients, accuracy and 'actionable' reporting) and language (conveying confidence and certainty, clarity and readability).</p> <p>In addition, we examined the included documents for any guidance regarding making reports more comprehensible to the clinician and/or patient, for example through suggesting lay summaries, altering or simplifying wording or provision of specific images or diagrams. Any specific advice regarding communication of findings and how this was conveyed (i.e. direct quotes) were also extracted. All findings were extracted and tabulated independently by two authors (C.F. and A.B.). Discordance was resolved by discussion and consensus.</p> <hd id="AN0143677006-10">Results</hd> <p>Of the 611 potentially eligible documents we identified, 27 were included for full-text review and six satisfied our eligibility criteria [[<reflink idref="bib6" id="ref14">6</reflink>], [<reflink idref="bib13" id="ref15">13</reflink>]–[<reflink idref="bib16" id="ref16">16</reflink>]] (Fig. 1). A further four documents were identified on the websites of the Spanish Society of Medical Radiology, Italian Society of Radiology, Latvian Association of Radiologists and German Roentgen Society; however, these were excluded as no English language versions of these documents were available. The included documents comprised the guidelines from RANZCR [[<reflink idref="bib7" id="ref17">7</reflink>]], the UK Royal College of Radiologists (RCR) [[<reflink idref="bib13" id="ref18">13</reflink>]], the ACR [[<reflink idref="bib6" id="ref19">6</reflink>]], the Canadian Association of Radiologists (CAR) [[<reflink idref="bib16" id="ref20">16</reflink>]], the Hong Kong College of Radiologists (HKCR) [[<reflink idref="bib14" id="ref21">14</reflink>]] and the European Society of Radiology (ESR) [[<reflink idref="bib15" id="ref22">15</reflink>]]. Three guidelines were published in the last 2 years [[<reflink idref="bib7" id="ref23">7</reflink>], [<reflink idref="bib13" id="ref24">13</reflink>]]. The ACR guidelines were revised most recently in 2014 and the ESR guidelines were published in 2011 and the CAR guidelines in 2010.</p> <hd id="AN0143677006-11">Guideline development process</hd> <p>Explanation regarding how each guideline was developed was variable (Table 1). All except the HKCR guidelines attributed development to committees, generally professional standards groups, and some named the individuals involved. The RANZCR guidelines state 'development was initially achieved by a multi-disciplinary team using a transparent and documented process of integration of evidence with expert opinion'. This is presumed to refer to an initial literature review [[<reflink idref="bib17" id="ref25">17</reflink>]] which informed a project managed by RANZCR resulting in an evidence-based guideline for the written radiology report [[<reflink idref="bib12" id="ref26">12</reflink>]]. The most recent RANZCR guidelines, included in this review [[<reflink idref="bib7" id="ref27">7</reflink>]], were preceded by an online survey of clinical radiologists with updates to the previous version clearly identified [[<reflink idref="bib18" id="ref28">18</reflink>]]. This was the only guideline to include a consumer as part of the development process and one of two (the other being the ACR) to include non-radiologist stakeholders in guideline development.</p> <p>Provenance of included guidelines</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th /><th><p>Author credited</p></th><th><p>Who wrote the guidelines?</p></th><th><p>How did they decide what to include?</p></th><th><p>Non-radiologists/other stakeholders included?</p></th></tr></thead><tbody><tr><td><p>Royal Australian and New Zealand College of Radiologists</p></td><td><p>Copyright—College</p></td><td><p>Quality Radiology Written Reports Working Group (members named)</p><p>Safety, Quality and Standards Committee and the Faculty of Clinical Radiology Council (not named)</p></td><td><p>Development described in background, 'based on a literature review'</p></td><td><p>Yes—in survey and original group</p></td></tr><tr><td><p>Royal College of Radiologists (United Kingdom)</p></td><td><p>Copyright—College</p><p>Principal author named in forward</p></td><td><p>Clinical Radiology Professional Support and standards Board</p><p>Clinical Radiology Faculty Board</p><p>Medical Director Professional Practice Clinical Radiology (journal)</p><p>Not all members named</p></td><td><p>Unclear</p></td><td><p>Nil evidence</p></td></tr><tr><td><p>American College of Radiology (USA)</p></td><td><p>ACR</p></td><td><p>Reviewing committee, Practice Parameters committee, Comments reconciliation committee (members named)</p></td><td><p>ACR guidelines on developing practice parameters—process clearly stated on website</p></td><td><p>Not clearly stated</p><p>However, the Committee on practice parameters (general, small and rural practice) was consulted and includes multiple non-radiologists.</p><p>Nil evidence of consumer inclusion</p></td></tr><tr><td><p>Canadian Association of Radiologists</p></td><td><p>College, also acknowledges ACR guidelines</p></td><td><p>Four authors named</p></td><td><p>Based on ACR guidelines, otherwise unclear</p></td><td><p>Nil evidence</p></td></tr><tr><td><p>European Society of Radiology</p></td><td><p>ESR</p></td><td><p>ESR subcommittee on Audit and standards (members named) and approved by executive council</p></td><td><p>Unclear</p></td><td><p>Nil evidence</p></td></tr><tr><td><p>Hong Kong College of Radiologists</p></td><td><p>None.</p><p>Acknowledges RCR 2012 guidelines and ESR guidelines</p></td><td><p>Unclear</p></td><td><p>Unclear</p></td><td><p>Nil evidence</p></td></tr></tbody></table> </ephtml> </p> <hd id="AN0143677006-12">Items covered across the guidelines</hd> <p>All guidelines included basic suggestions regarding items to include in a radiology report (Table 2), and most with the exception of the HKCR suggested the following reporting sequence: clinical information, relevant findings, addressing the clinical question, providing differential diagnoses where required, and conclusion. The RANZCR guidelines included all the recommendations for written radiology reports regarding technical information and content based upon the template which was developed for this purpose. The HKCR guidelines were most limited, with a focus on timeliness and communication methods for radiological findings rather than report content. All other guidelines recommended the inclusion of technical information such as technique, examination quality, comparison with prior studies and procedural details. The same five guidelines recommended information regarding clinical history, relevant or abnormal findings, addressing the clinical question, differential diagnosis and conclusion. All six guidelines discussed recommendations for further testing or treatment, but only three recommended reporting normal findings [[<reflink idref="bib7" id="ref29">7</reflink>], [<reflink idref="bib13" id="ref30">13</reflink>], [<reflink idref="bib15" id="ref31">15</reflink>]]. Documentation of any discrepancies between an initial and final report was recommended in three guidelines [[<reflink idref="bib6" id="ref32">6</reflink>], [<reflink idref="bib16" id="ref33">16</reflink>]].</p> <p>Comparison of advice to radiologists regarding items to include in imaging findings</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th /><th><p>Royal Australian and New Zealand College of Radiologists</p></th><th><p>Royal College of Radiologists (UK)</p></th><th><p>American College of Radiology</p></th><th><p>Canadian Association of Radiologists</p></th><th><p>European Society of Radiology</p></th><th><p>Hong Kong College of Radiologists</p></th></tr></thead><tbody><tr><td colspan="7"><p>Technical information</p></td></tr><tr><td><p> Patient demographics</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td /><td /></tr><tr><td><p> Report status</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td /><td /></tr><tr><td><p> Comparison with prior studies</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td /></tr><tr><td><p> Technique</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td /></tr><tr><td><p> Procedural description</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td /></tr><tr><td><p> Examination quality</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td /></tr><tr><td colspan="7"><p>Content</p></td></tr><tr><td><p> History/clinical information</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td /></tr><tr><td><p> Relevant or abnormal findings</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td /></tr><tr><td><p> Normal findings</p></td><td><p>✓</p></td><td><p>✓</p></td><td /><td /><td><p>✓</p></td><td /></tr><tr><td><p> Addressing the clinical question</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td /></tr><tr><td><p> Differential diagnosis</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td /></tr><tr><td><p> Conclusion</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td /></tr><tr><td><p> Testing or treatment recommendations</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td><td><p>✓</p></td></tr><tr><td><p> Discrepancy documentation</p></td><td><p>✓</p></td><td /><td><p>✓</p></td><td><p>✓</p></td><td /><td /></tr></tbody></table> </ephtml> </p> <hd id="AN0143677006-13">Target audience for report</hd> <p>All guidelines emphasise the need for accuracy, consider the referring physician the main audience and provide structure around language required. All encourage 'actionable' reporting, where radiology images are transformed into reports that assist patient care and influence outcome [[<reflink idref="bib19" id="ref34">19</reflink>]]. Four guidelines recommend the use of terminology should consider the referring clinician's background and not be overly technical [[<reflink idref="bib6" id="ref35">6</reflink>], [<reflink idref="bib13" id="ref36">13</reflink>], [<reflink idref="bib15" id="ref37">15</reflink>]]. Only two guidelines explicitly note patients and/or their carers may view results and recommend this be considered in reporting [[<reflink idref="bib7" id="ref38">7</reflink>], [<reflink idref="bib13" id="ref39">13</reflink>]].</p> <hd id="AN0143677006-14">Discussions of clinical certainty</hd> <p>Three guidelines [[<reflink idref="bib7" id="ref40">7</reflink>], [<reflink idref="bib13" id="ref41">13</reflink>], [<reflink idref="bib16" id="ref42">16</reflink>]] discuss reporting with confidence or certainty. All guidelines make some reference to the report being 'clear' [[<reflink idref="bib13" id="ref43">13</reflink>]–[<reflink idref="bib15" id="ref44">15</reflink>]] or advocate for brevity [[<reflink idref="bib7" id="ref45">7</reflink>]], and most suggest that the final report should be carefully reviewed to ensure there are no 'confusing or conflicting statements' [[<reflink idref="bib16" id="ref46">16</reflink>]]. Two guidelines make some reference to the readability of the report [[<reflink idref="bib7" id="ref47">7</reflink>], [<reflink idref="bib15" id="ref48">15</reflink>]], although the ESR guidelines merely suggest avoiding 'long descriptions of limited use to the referrer'. The RANZCR guidelines make direct reference to readability, which appears to be used interchangeably with the notion of clarity. However, this is not clearly defined in the guidelines or the papers on which the guidelines were based [[<reflink idref="bib12" id="ref49">12</reflink>], [<reflink idref="bib17" id="ref50">17</reflink>]]. One guideline suggests including 'a conclusion or summary of the key findings in the clinical context' [[<reflink idref="bib13" id="ref51">13</reflink>]]. No guidelines in this review considered provision of lay summaries aimed at patients (Table 3).</p> <p>Comparison of advice to radiologists regarding communication of imaging findings</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th /><th><p>Royal Australian and New Zealand College of Radiologists</p></th><th><p>Royal College of Radiologists (UK)</p></th><th><p>American College of Radiology</p></th><th><p>Canadian College of Radiologists</p></th><th><p>European Society of Radiology</p></th><th><p>Hong Kong College of Radiology</p></th></tr></thead><tbody><tr><td><p>Purpose of the report</p></td><td><p>Not discussed</p></td><td><p>'The purpose of an imaging report is to provide an accurate interpretation of images in a format that will prompt appropriate care for the patient'</p></td><td><p>'The final report is the definitive documentation of the results of an imaging examination or procedure'</p></td><td><p>'The effective transmission of imaging information from the radiologist to the referring physician constitutes the main purpose of the report'</p></td><td><p>'The written radiology report is the most important means of communication between the radiologist and referring medical doctor'</p></td><td><p>'..the written radiology report constitutes the legal record of the radiology investigation or procedure'</p></td></tr><tr><td><p>Length</p></td><td><p>'Reports should be as concise as possible while still conveying the information required....'</p></td><td><p>'Where there is a need for a long descriptive report, it should conclude with a short summary of key findings and their interpretation...'</p></td><td><p>Not discussed</p></td><td><p>'The ideal radiology report is ....concise'</p></td><td><p>'A balance needs to be struck between a clear description of the positive and negative findings and the concentration of the reader'</p></td><td><p>'[The responsibility of the radiologist is to] '...ensure that the reports are....precise'</p></td></tr><tr><td><p>Templated or structured reporting</p></td><td><p>'Standardised examination/disease process-specific templates should be developed where they are likely to improve the quality of communication...'</p></td><td><p>Not discussed</p></td><td><p>'Standardized computer-generated reports should be designed to satisfy the above criteria'</p></td><td><p>'Standardized computer-generated template reports (or other structured report formats) that satisfy the above criteria are considered to conform to these standards'</p></td><td><p>'[Structured reporting]...is more time efficient than dictation....has also been suggested to improve communication of radiology results...'</p></td><td><p>Not discussed</p></td></tr><tr><td><p>Terminology—referring clinician</p></td><td><p>'...should use terminology with widely understood and commonly agreed meaning among health care practitioners.'</p></td><td><p>'The wording of the report is likely to differ when it is written to a general practitioner who may be unfamiliar with a relatively rare condition, compared with a specialist in that particular field'</p></td><td><p>Not discussed</p></td><td><p>Not discussed</p></td><td><p>'The wording of the report should take into account the expected level of knowledge and expertise of the referrer'</p></td><td><p>Not discussed</p></td></tr><tr><td><p>Terminology—patients</p></td><td><p>'...bear in mind that a consumer may also read the report'</p></td><td><p>'Patients now have access to medical correspondence about them... This should be borne in mind in the wording and style of the report'</p></td><td><p>Not discussed</p></td><td><p>Not discussed</p></td><td><p>Not discussed</p></td><td><p>Not discussed</p></td></tr><tr><td><p>Accuracy</p></td><td><p>'Relevant imaging findings should be characterised as specifically as possible'</p></td><td><p>'....[the reporter] should be aware of the likely accuracy of the examination in that particular patient related to the published accuracy of the technique and its applicability to this particular examination.....'</p></td><td><p>'The report should use appropriate anatomic, pathologic, and radiologic terminology to describe the findings'</p></td><td><p>'Use precise anatomical, radiological and pathological terminology to describe the findings accurately'</p></td><td><p>'[The findings] section should include a targeted, systematic and comprehensive description of all abnormalities....the description should be specific...'</p></td><td><p>'It is ...vital that the information contained within this record is accurate...'</p></td></tr><tr><td><p>'Actionable reporting'</p></td><td><p>'Specific clinical questions asked by the referrer must be addressed....'</p></td><td><p>'A radiology report should be actionable and prompt appropriate care for the patient'</p></td><td><p>'A specific diagnosis should be given when possible....a differential diagnosis should be rendered when appropriate...'</p></td><td><p>'Give a precise diagnosis whenever possible... give a differential diagnosis when appropriate'</p></td><td><p>'The report may give suggestions for further action to be taken....these suggestions should be carefully considered...'</p></td><td><p>[The responsibility of the radiologist is to] '...clearly document advice on further management or action, where appropriate'</p></td></tr><tr><td><p>Confidence and certainty</p></td><td><p>'[The report should] avoid vague modifiers such as "might be consistent with" and "possibly represents"'</p></td><td><p>'The level of certainty or doubt surrounding an imaging diagnosis should be clearly indicated in the report'</p></td><td><p>Not discussed</p></td><td><p>'Descriptive reporting that offers no opinion, or guidance for the resolution of the clinical question should generally be avoided'</p></td><td><p>Not discussed</p></td><td><p>Not discussed</p></td></tr><tr><td><p>Clarity</p></td><td><p>'[The report should] use short sentences in preference to long sentences in prose reports and in the free text fields of itemised reports'</p></td><td><p>'The written report should be clear, and written in a way appropriate to the referrer's expected level of familiarity with the imaging abnormalities detected.....'</p></td><td><p>'Use of abbreviations or acronyms should be limited to avoid ambiguity'</p></td><td><p>'The report should be clear and concise'</p></td><td><p>'Observations should be as precise as possible, avoiding loose terms...'</p></td><td><p>[The responsibility of the radiologist is to] '...ensure reports are ...clear and precise'</p></td></tr><tr><td><p>Readability</p></td><td><p>'Clinical radiologists should review, edit and sign/authorise their own reports....to improve accuracy, clarity, readability, succinctness and logical order or examination findings, and their interpretation'</p></td><td><p>Not discussed</p></td><td><p>Not discussed</p></td><td><p>Not discussed</p></td><td><p>'Long descriptions of limited use to the referrer should be avoided'</p></td><td><p>Not discussed</p></td></tr></tbody></table> </ephtml> </p> <hd id="AN0143677006-15">Discussion</hd> <p>Based upon the six English language guidelines we were able to access, most tend to focus on structure of the report and technical information. Three guidelines encourage radiologists to consider the specialty and background of the referring clinician, while two acknowledge that patients may access their reports. Recommendations regarding format and language are inconsistent between guidelines. Only one guideline suggests the inclusion of clinical context [[<reflink idref="bib13" id="ref52">13</reflink>]], and no guideline recommends inclusion of a lay summary for patients. All guidelines suggest providing recommendations for further testing or treatment where appropriate.</p> <p>Imaging reports are powerful. Radiologist recommendations in the report influence whether patients are referred for further testing [[<reflink idref="bib20" id="ref53">20</reflink>]], while report reminders regarding evidence-based practice can result in changes in prescribing [[<reflink idref="bib21" id="ref54">21</reflink>]] and imaging referrals [[<reflink idref="bib23" id="ref55">23</reflink>]]. Despite this, only the RCR and RANZCR guidelines acknowledge that the way the imaging report is presented can impact patient management. The RCR guidelines state 'the purpose of a radiology report is to provide an accurate interpretation of images in a format that will prompt appropriate care for the patient' [[<reflink idref="bib13" id="ref56">13</reflink>]], and the RANZCR guidelines acknowledge the radiology report '...has an important impact on decisions about further investigation and management. Its form and content can be influential in reducing harm to patients...' [[<reflink idref="bib12" id="ref57">12</reflink>]]. With increasing accessibility of sensitive imaging modalities such as CT and MRI, the likelihood of identifying unexpected or incidental anatomical abnormalities has increased. Such incidental findings can be more common than the condition for which the imaging is being performed to detect [[<reflink idref="bib24" id="ref58">24</reflink>]]. While detailed reporting can enable the clinician to match radiological features to the patient's symptoms, with increasing detection of low-risk incidental findings comes a need to ensure imaging reports convey findings in a manner that enables accurate clinical decision-making and minimises potential patient harms from overdetection.</p> <p>Structured reporting was discussed by four of the guidelines in this review [[<reflink idref="bib6" id="ref59">6</reflink>], [<reflink idref="bib15" id="ref60">15</reflink>]], although in one it is discussed as a potential future development [[<reflink idref="bib15" id="ref61">15</reflink>]] and in two it was suggested that any structured report should include the information included in that guideline [[<reflink idref="bib6" id="ref62">6</reflink>], [<reflink idref="bib16" id="ref63">16</reflink>]]. Only the RANZCR guidelines considered structured reporting in any depth, stating 'Standardised....templates should be developed where they are likely to improve the quality of communication, and in particular, to meet the content requirements of specific referrer groups'. This ambiguity may be reflected in one Australian survey, where only 32.5% of oncologists reported regularly receiving structured reports, and 21% never received them, despite expressing a strong preference for such reports [[<reflink idref="bib25" id="ref64">25</reflink>]]. Alongside being a possible solution to radiology report interpretation issues such as error rate [[<reflink idref="bib26" id="ref65">26</reflink>]] and clarity [[<reflink idref="bib27" id="ref66">27</reflink>]] and for clinical situations such as surgical planning [[<reflink idref="bib28" id="ref67">28</reflink>]], clinicians can extract information from structured reports more easily [[<reflink idref="bib29" id="ref68">29</reflink>]] and it can improve agreement between clinicians regarding the interpretation of findings [[<reflink idref="bib31" id="ref69">31</reflink>]].</p> <p>Providing structured reports alone may not be enough. Primary care physicians require certainty and clinical context from radiology reports. They prefer clear indications of the meaning of radiology terminology, likelihood of disease and clinical relevance of findings [[<reflink idref="bib32" id="ref70">32</reflink>]], including the normal sizes of anatomical structures [[<reflink idref="bib33" id="ref71">33</reflink>]]. Three guidelines in this review suggest using terminology that is widely understood or appropriate to the background of the referring clinician, and three discuss conveying confidence and certainty, but only one recommends clear statements regarding the likelihood of disease. Clinicians are more likely than radiologists to prefer the inclusion of negative findings [[<reflink idref="bib34" id="ref72">34</reflink>]], something considered only by the RANZCR guidelines. Although all guidelines recommended giving treatment or management suggestions in the report, only primary care physicians appreciate this information [[<reflink idref="bib35" id="ref73">35</reflink>]], and when suggestions are given, most clinicians feel obliged to follow recommendations [[<reflink idref="bib36" id="ref74">36</reflink>]].</p> <p>Although patients desire access to their report [[<reflink idref="bib37" id="ref75">37</reflink>]], and are increasingly receiving it through their electronic medical records, only two guidelines consider the patient, and only to state that the reporting radiologist should consider that the patient may read the report. Methods to reduce patient distress and anxiety that have been explored include rewording imaging reports to use simpler and more neutral language [[<reflink idref="bib38" id="ref76">38</reflink>]], including patient-oriented explanations of complex medical terms along with diagrams [[<reflink idref="bib39" id="ref77">39</reflink>]], and lay language summaries [[<reflink idref="bib41" id="ref78">41</reflink>]]. Insertion of benchmark epidemiological data providing information similar to normal ranges for laboratory tests has also been proposed and investigated [[<reflink idref="bib42" id="ref79">42</reflink>]]. No guidelines in this review suggested aiming reports at a specific literacy level, or using reporting techniques preferred by patients undergoing imaging.</p> <p>This paper has a number of strengths and limitations. The broad search strategy ensured that all professional association websites were searched and that any published guidelines were identified. Our study is limited to guidelines produced by professional member bodies and may not represent all reporting guidelines used by radiologists. The inclusion of only English language documents may mean our results are not generalizable to guidelines in other languages.</p> <p>Current radiology reporting guidelines do not reflect the preferences expressed by referring clinicians and patients for radiology report comprehensibility. In practice, while radiology reports that conform with reporting guidelines are likely to be technically accurate, these may not be understood by the referring clinician and patient in the way intended. This may lead to anxiety and potentially unnecessary tests or treatment. Given the role radiology reports play in clinical decision-making, professional radiology member organisations have a responsibility to ensure that their guidance to members considers the clarity of radiology reports for referrers and patients. We recommend that future guideline development panels include end-users including consumers to ensure the requirements of these groups are met. This review identifies how guidelines can encourage radiologists to optimise the diagnostic imaging report to best meet the needs of referring clinicians and patients.</p> <hd id="AN0143677006-16">Funding</hd> <p>This study was supported by a National Health and Medical Research Council (NHMRC) programme grant (APP1113532). DOC is supported by an NHMRC TRIP Fellowship (APP1168749). JGJ is supported by the National Institute of Arthritis And Musculoskeletal And Skin Diseases of the National Institutes of Health under Award Number P30AR072572. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. RB is supported by an NHMRC Senior Principal Research Fellowship (ID 1082138). No funding body had direct involvement in any facet of the design of the study, collection, analysis or interpretation of the data or writing of the manuscript.</p> <hd id="AN0143677006-17">Authors' contributions</hd> <p>All authors contributed to the conception or design of the work and the writing and revision of the manuscript. CF and AB extracted and analysed the data regarding the guidelines. The authors read and approved the final manuscript.</p> <hd id="AN0143677006-18">Availability of data and materials</hd> <p>All guidelines used in this review are publicly available on the website of the relevant radiology college. Other data and materials will be shared by the authors upon reasonable request.</p> <hd id="AN0143677006-19">Ethics approval and consent to participate</hd> <p>Not applicable</p> <hd id="AN0143677006-20">Consent for publication</hd> <p>Not applicable</p> <hd id="AN0143677006-21">Competing interests</hd> <p>During the conduct of the review, JJ reports grants from the National Institute of Arthritis, Musculoskeletal and Skin Diseases (NIAMS/NIH) and relationships with Springer Publishing and the GE-Association of University Radiologists Radiology Research Academic Fellowship (GERRAF): Faculty Board of Review. The other authors declare no conflict of interest.</p> <p></p> <p>• ACR</p> <p></p> <ulist> <item> American College of Radiology</item> <p></p> </ulist> <p>• CAR</p> <p></p> <ulist> <item> Canadian Association of Radiologists</item> <p></p> </ulist> <p>• CT</p> <p></p> <ulist> <item> Computed tomography</item> <p></p> </ulist> <p>• ESR</p> <p></p> <ulist> <item> European Society of Radiology</item> <p></p> </ulist> <p>• HKCR</p> <p></p> <ulist> <item> Hong Kong College of Radiology</item> <p></p> </ulist> <p>• MRI</p> <p></p> <ulist> <item> Magnetic resonance imaging</item> <p></p> </ulist> <p>• PRISMA</p> <p></p> <ulist> <item> Preferred Reporting Items for Systematic Reviews and Meta-Analyses</item> <p></p> <item> PRISMA-ScR</item> <p></p> <item> Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Scoping Review</item> <p></p> </ulist> <p>• RANZCR</p> <p></p> <ulist> <item> Royal Australian and New Zealand College of Radiologists</item> <p></p> </ulist> <p>• RCR</p> <p></p> <ulist> <item> Royal College of Radiologists</item> <p></p> </ulist> <p>• TI-RADS</p> <p></p> <ulist> <item> Thyroid Imaging Reporting and Data System</item> </ulist> <hd id="AN0143677006-22">Publisher's Note</hd> <p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p> <ref id="AN0143677006-23"> <title> References </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> Wallis A, McCoubrie P. The radiology report--are we getting the message across?. Clin Radiol. 2011; 66; 11: 1015-1022. 10.1016/j.crad.2011.05.013</bibtext> </blist> <blist> <bibl id="bib2" idref="ref2" type="bt">2</bibl> <bibtext> Bosmans JM, Weyler JJ, Parizel PM. Structure and content of radiology reports, a quantitative and qualitative study in eight medical centers. Eur J Radiol. 2009; 72; 2: 354-358. 10.1016/j.ejrad.2008.06.023</bibtext> </blist> <blist> <bibl id="bib3" idref="ref3" type="bt">3</bibl> <bibtext> Rosenkrantz AB. Differences in perceptions among radiologists, referring physicians, and patients regarding language for incidental findings reporting. AJR Am J Roentgenol. 2017; 208; 1: 140-143. 10.2214/AJR.16.16633</bibtext> </blist> <blist> <bibl id="bib4" idref="ref4" type="bt">4</bibl> <bibtext> Khorasani R, Bates DW, Teeger S, Rothschild JM, Adams DF, Seltzer SE. Is terminology used effectively to convey diagnostic certainty in radiology reports?. Acad Radiol. 2003; 10; 6: 685-688. 10.1016/S1076-6332(03)80089-2</bibtext> </blist> <blist> <bibl id="bib5" idref="ref5" type="bt">5</bibl> <bibtext> Nickel B, Barratt A, Copp T, Moynihan R, McCaffery K. Words do matter: a systematic review on how different terminology for the same condition influences management preferences. BMJ Open. 2017; 7; 7: e014129. 10.1136/bmjopen-2016-014129</bibtext> </blist> <blist> <bibl id="bib6" idref="ref6" type="bt">6</bibl> <bibtext> American College of Radiology (2014) ACR Practice parameter for communication of diagnostic imaging findings.</bibtext> </blist> <blist> <bibl id="bib7" idref="ref7" type="bt">7</bibl> <bibtext> The Royal Australian and New Zealand College of Radiologists (2017) Clinical radiology written report guide. The Royal Australian and New Zealand College of Radiologists: Sydney, Australia.</bibtext> </blist> <blist> <bibl id="bib8" idref="ref8" type="bt">8</bibl> <bibtext> Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005; 8; 1: 19-32. 10.1080/1364557032000119616</bibtext> </blist> <blist> <bibl id="bib9" idref="ref9" type="bt">9</bibl> <bibtext> Levac D, Colquhoun H, O'Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010; 5: 69. 10.1186/1748-5908-5-69</bibtext> </blist> <blist> <bibtext> Tricco AC, Lillie E, Zarin W. PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018; 169; 7: 467-473. 10.7326/M18-0850</bibtext> </blist> <blist> <bibtext> Tessler FN, Middleton WD, Grant EG. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): white paper of the ACR TI-RADS Committee. J Am Coll Radiol. 2017; 14; 5: 587-595. 10.1016/j.jacr.2017.01.046</bibtext> </blist> <blist> <bibtext> Goergen SK, Pool FJ, Turner TJ. Evidence-based guideline for the written radiology report: methods, recommendations and implementation challenges. J Med Imaging Radiat Oncol. 2013; 57; 1: 1-7. 10.1111/1754-9485.12014</bibtext> </blist> <blist> <bibtext> The Royal College of Radiologists (2018) Standards for interpretation and reporting of imaging investigations. The Royal College of Radiologists: London, UK.</bibtext> </blist> <blist> <bibtext> Hong Kong College of Radiologists (2017) Guide on good medical practice for radiologists.</bibtext> </blist> <blist> <bibtext> European Society of Radiology (ESR). Good practice for radiological reporting. Guidelines from the European Society of Radiology (ESR). Insights Into Imaging. 2011; 2; 2: 93-96. 10.1007/s13244-011-0066-7</bibtext> </blist> <blist> <bibtext> Canadian Association of Radiologists (2010) Standard for communication of diagnostic imaging finding. Canadian Association of Radiologists: Ottawa, Canada.</bibtext> </blist> <blist> <bibtext> Pool F, Goergen S. Quality of the written radiology report: a review of the literature. J Am Coll Radiol. 2010; 7; 8: 634-643. 10.1016/j.jacr.2010.03.016</bibtext> </blist> <blist> <bibtext> Pool FJ, Siemienowicz ML. New RANZCR clinical radiology written report guidelines. J Med Imaging Radiat Oncol. 2019; 63; 1: 7-14. 10.1111/1754-9485.12756</bibtext> </blist> <blist> <bibtext> Boland GW, Enzmann DR, Duszak R Jr. Actionable reporting. J Am Coll Radiol. 2014; 11; 9: 844-845. 10.1016/j.jacr.2014.06.002</bibtext> </blist> <blist> <bibtext> Wickramarachchi BN, Meyer-Rochow GY, McAnulty K, Conaglen JV, Elston MS. Adherence to adrenal incidentaloma guidelines is influenced by radiology report recommendations. ANZ J Surg. 2016; 86; 6: 483-486. 10.1111/ans.12799</bibtext> </blist> <blist> <bibtext> Heidenreich PA, Gholami P, Sahay A, Massie B, Goldstein MK. Clinical reminders attached to echocardiography reports of patients with reduced left ventricular ejection fraction increase use of beta-blockers: a randomized trial. Circulation. 2007; 115; 22: 2829-2834. 10.1161/CIRCULATIONAHA.106.684753</bibtext> </blist> <blist> <bibtext> Heidenreich PA, Chacko M, Goldstein MK, Atwood JE. ACE inhibitor reminders attached to echocardiography reports of patients with reduced left ventricular ejection fraction. Am J Med. 2005; 118; 9: 1034-1037. 10.1016/j.amjmed.2004.12.028</bibtext> </blist> <blist> <bibtext> Eccles M, Steen N, Grimshaw J. Effect of audit and feedback, and reminder messages on primary-care radiology referrals: a randomised trial. Lancet. 2001; 357; 9266: 1406-1409. 10.1016/S0140-6736(00)04564-5</bibtext> </blist> <blist> <bibtext> Hall WB, Truitt SG, Scheunemann LP. The prevalence of clinically relevant incidental findings on chest computed tomographic angiograms ordered to diagnose pulmonary embolism. Arch Intern Med. 2009; 169; 21: 1961-1965. 10.1001/archinternmed.2009.360</bibtext> </blist> <blist> <bibtext> Koczwara B, Tie M, Esterman A. Are radiologists meeting the needs of Australian medical oncologists? Results of a national survey. Australas Radiol. 2003; 47; 3: 268-273. 10.1046/j.1440-1673.2003.01179.x</bibtext> </blist> <blist> <bibtext> Hawkins CM, Hall S, Zhang B, Towbin AJ. Creation and implementation of department-wide structured reports: an analysis of the impact on error rate in radiology reports. J Digit Imaging. 2014; 27; 5: 581-587. 10.1007/s10278-014-9699-7</bibtext> </blist> <blist> <bibtext> Johnson AJ, Chen MY, Zapadka ME, Lyders EM, Littenberg B. Radiology report clarity: a cohort study of structured reporting compared with conventional dictation. J Am Coll Radiol. 2010; 7; 7: 501-506. 10.1016/j.jacr.2010.02.008</bibtext> </blist> <blist> <bibtext> Norenberg D, Sommer WH, Thasler W. Structured reporting of rectal magnetic resonance imaging in suspected primary rectal cancer: potential benefits for surgical planning and interdisciplinary communication. Invest Radiol. 2017; 52; 4: 232-239. 10.1097/RLI.0000000000000336</bibtext> </blist> <blist> <bibtext> Gassenmaier S, Armbruster M, Haasters F. Structured reporting of MRI of the shoulder - improvement of report quality?. Eur Radiol. 2017; 27; 10: 4110-4119. 10.1007/s00330-017-4778-z</bibtext> </blist> <blist> <bibtext> Barbosa F, Maciel LM, Vieira EM, Azevedo Marques PM, Elias J, Muglia VF. Radiological reports: a comparison between the transmission efficiency of information in free text and in structured reports. Clinics (Sao Paulo). 2010; 65; 1: 15-21. 10.1590/S1807-59322010000100004</bibtext> </blist> <blist> <bibtext> Bastuji-Garin S, Schaeffer A, Wolkenstein P. Pulmonary embolism; lung scanning interpretation: about words. Chest. 1998; 114; 6: 1551-1555. 10.1378/chest.114.6.1551</bibtext> </blist> <blist> <bibtext> Espeland A, Baerheim A. General practitioners' views on radiology reports of plain radiography for back pain. Scand J Prim Health Care. 2007; 25; 1: 15-19. 10.1080/02813430600973459</bibtext> </blist> <blist> <bibtext> Grieve FM, Plumb AA, Khan SH. Radiology reporting: a general practitioner's perspective. Br J Radiol. 2010; 83; 985: 17-22. 10.1259/bjr/16360063</bibtext> </blist> <blist> <bibtext> Johnson AJ, Ying J, Swan JS, Williams LS, Applegate KE, Littenberg B. Improving the quality of radiology reporting: a physician survey to define the target. J Am Coll Radiol. 2004; 1; 7: 497-505. 10.1016/j.jacr.2004.02.019</bibtext> </blist> <blist> <bibtext> Ghali Eskander M, Leung A, Lee D. Style and content of CT and MR imaging lumbar spine reports: radiologist and clinician preferences. AJNR Am J Neuroradiol. 2010; 31; 10: 1842-1847. 10.3174/ajnr.A2218</bibtext> </blist> <blist> <bibtext> Gunn AJ, Sahani DV, Bennett SE, Choy G. Recent measures to improve radiology reporting: perspectives from primary care physicians. J Am Coll Radiol. 2013; 10; 2: 122-127. 10.1016/j.jacr.2012.08.013</bibtext> </blist> <blist> <bibtext> Cabarrus M, Naeger DM, Rybkin A, Qayyum A. Patients prefer results from the ordering provider and access to their radiology reports. J Am Coll Radiol. 2015; 12; 6: 556-562. 10.1016/j.jacr.2014.12.009</bibtext> </blist> <blist> <bibtext> Bossen JK, Hageman MG, King JD, Ring DC. Does rewording MRI reports improve patient understanding and emotional response to a clinical report?. Clin Orthop Relat Res. 2013; 471; 11: 3637-3644. 10.1007/s11999-013-3100-x</bibtext> </blist> <blist> <bibtext> Cook TS, Oh SC, Kahn CE Jr. Patients' use and evaluation of an online system to annotate radiology reports with lay language definitions. Acad Radiol. 2017; 24; 9: 1169-1174. 10.1016/j.acra.2017.03.005</bibtext> </blist> <blist> <bibtext> Hong MK, Feustel C, Agnihotri M, Silverman M, Simoneaux SF, Wilcox L. Supporting families in reviewing and communicating about radiology imaging studies. Proc SIGCHI Conf Hum Factor Comput Syst. 2017; 2017: 5245-5256. 10.1145/3025453.3025754</bibtext> </blist> <blist> <bibtext> Gunn AJ, Gilcrease-Garcia B, Mangano MD, Sahani DV, Boland GW, Choy G. JOURNAL CLUB: structured feedback from patients on actual radiology reports: a novel approach to improve reporting practices. AJR Am J Roentgenol. 2017; 208; 6: 1262-1270. 10.2214/AJR.16.17584</bibtext> </blist> <blist> <bibtext> Jarvik JG, BA Comstock, KT James et al (2015) Lumbar imaging with reporting of epidemiology (LIRE)--protocol for a pragmatic cluster randomized trial. Contemp Clin Trials 45:157–163</bibtext> </blist> <blist> <bibtext> McCullough BJ, Johnson GR, Martin BI, Jarvik JG. Lumbar MR imaging and reporting epidemiology: do epidemiologic data in reports affect clinical management?. Radiology. 2012; 262; 3: 941-946. 10.1148/radiol.11110618</bibtext> </blist> </ref> <aug> <p>By Caitlin I. Farmer; Allison M. Bourne; Denise O'Connor; Jeffrey G. Jarvik and Rachelle Buchbinder</p> <p>Reported by Author; Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib10" firstref="ref10"></nolink> <nolink nlid="nl2" bibid="bib11" firstref="ref11"></nolink> <nolink nlid="nl3" bibid="bib12" firstref="ref12"></nolink> <nolink nlid="nl4" bibid="bib13" firstref="ref15"></nolink> <nolink nlid="nl5" bibid="bib16" firstref="ref16"></nolink> <nolink nlid="nl6" bibid="bib14" firstref="ref21"></nolink> <nolink nlid="nl7" bibid="bib15" firstref="ref22"></nolink> <nolink nlid="nl8" bibid="bib17" firstref="ref25"></nolink> <nolink nlid="nl9" bibid="bib18" firstref="ref28"></nolink> <nolink nlid="nl10" bibid="bib19" firstref="ref34"></nolink> <nolink nlid="nl11" bibid="bib20" firstref="ref53"></nolink> <nolink nlid="nl12" bibid="bib21" firstref="ref54"></nolink> <nolink nlid="nl13" bibid="bib23" firstref="ref55"></nolink> <nolink nlid="nl14" bibid="bib24" firstref="ref58"></nolink> <nolink nlid="nl15" bibid="bib25" firstref="ref64"></nolink> <nolink nlid="nl16" bibid="bib26" firstref="ref65"></nolink> <nolink nlid="nl17" bibid="bib27" firstref="ref66"></nolink> <nolink nlid="nl18" bibid="bib28" firstref="ref67"></nolink> <nolink nlid="nl19" bibid="bib29" firstref="ref68"></nolink> <nolink nlid="nl20" bibid="bib31" firstref="ref69"></nolink> <nolink nlid="nl21" bibid="bib32" firstref="ref70"></nolink> <nolink nlid="nl22" bibid="bib33" firstref="ref71"></nolink> <nolink nlid="nl23" bibid="bib34" firstref="ref72"></nolink> <nolink nlid="nl24" bibid="bib35" firstref="ref73"></nolink> <nolink nlid="nl25" bibid="bib36" firstref="ref74"></nolink> <nolink nlid="nl26" bibid="bib37" firstref="ref75"></nolink> <nolink nlid="nl27" bibid="bib38" firstref="ref76"></nolink> <nolink nlid="nl28" bibid="bib39" firstref="ref77"></nolink> <nolink nlid="nl29" bibid="bib41" firstref="ref78"></nolink> <nolink nlid="nl30" bibid="bib42" firstref="ref79"></nolink>
CustomLinks:
  – Url: https://resolver.ebsco.com/c/xy5jbn/result?sid=EBSCO:edsdoj&genre=article&issn=18694101&ISBN=&volume=11&issue=1&date=20200501&spage=1&pages=1-10&title=Insights into Imaging&atitle=Enhancing%20clinician%20and%20patient%20understanding%20of%20radiology%20reports%3A%20a%20scoping%20review%20of%20international%20guidelines&aulast=Caitlin%20I.%20Farmer&id=DOI:10.1186/s13244-020-00864-9
    Name: Full Text Finder (for New FTF UI) (s8985755)
    Category: fullText
    Text: Find It @ SCU Libraries
    MouseOverText: Find It @ SCU Libraries
  – Url: https://doaj.org/article/a9b29d293bca4809bd8a2dabf5956ffd
    Name: EDS - DOAJ (s8985755)
    Category: fullText
    Text: View record from DOAJ
    MouseOverText: View record from DOAJ
Header DbId: edsdoj
DbLabel: Directory of Open Access Journals
An: edsdoj.9b29d293bca4809bd8a2dabf5956ffd
RelevancyScore: 943
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 942.669494628906
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Enhancing clinician and patient understanding of radiology reports: a scoping review of international guidelines
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Caitlin+I%2E+Farmer%22">Caitlin I. Farmer</searchLink><br /><searchLink fieldCode="AR" term="%22Allison+M%2E+Bourne%22">Allison M. Bourne</searchLink><br /><searchLink fieldCode="AR" term="%22Denise+O%27Connor%22">Denise O’Connor</searchLink><br /><searchLink fieldCode="AR" term="%22Jeffrey+G%2E+Jarvik%22">Jeffrey G. Jarvik</searchLink><br /><searchLink fieldCode="AR" term="%22Rachelle+Buchbinder%22">Rachelle Buchbinder</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: Insights into Imaging, Vol 11, Iss 1, Pp 1-10 (2020)
– Name: Publisher
  Label: Publisher Information
  Group: PubInfo
  Data: SpringerOpen, 2020.
– Name: DatePubCY
  Label: Publication Year
  Group: Date
  Data: 2020
– Name: Subset
  Label: Collection
  Group: HoldingsInfo
  Data: LCC:Medical physics. Medical radiology. Nuclear medicine
– Name: Subject
  Label: Subject Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Comprehension%22">Comprehension</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnostic+imaging%22">Diagnostic imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Guidelines+as+topic%22">Guidelines as topic</searchLink><br /><searchLink fieldCode="DE" term="%22Radiology%22">Radiology</searchLink><br /><searchLink fieldCode="DE" term="%22Review%22">Review</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+physics%2E+Medical+radiology%2E+Nuclear+medicine%22">Medical physics. Medical radiology. Nuclear medicine</searchLink><br /><searchLink fieldCode="DE" term="%22R895-920%22">R895-920</searchLink>
– Name: Abstract
  Label: Description
  Group: Ab
  Data: Abstract Imaging reports are the primary method of communicating diagnostic imaging findings between the radiologist and the referring clinician. Guidelines produced by professional bodies provide guidance on content and format of imaging reports, but the extent to which they consider comprehensibility for referring clinicians and their patients is unclear. The objective of this review was to determine the extent to which radiology reporting guidelines consider comprehensibility of imaging reports for referring clinicians and patients. We performed a scoping review of English-language diagnostic imaging reporting guidelines. We searched electronic databases (OVID MEDLINE, Embase) and websites of radiological professional organisations to identify guidelines. The extent to which the guidelines recommended essential report features such as technical information, content, format and language, as well as features to enhance comprehensibility, such as lay language summaries, was recorded. Six guidelines from professional bodies representing radiologists from the USA, Canada, Australia and New Zealand, Hong Kong, the UK and Europe were identified from the search. Inconsistencies exist between guidelines in their recommendations, and they rarely consider that patients may read the report. No guideline made recommendations about the reporting of results considering the clinical context, and none recommended features preferred by patients such as lay language summaries. This review identifies an opportunity for future radiology reporting guidelines to give greater consideration to referring clinician and patient preferences.
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: article
– Name: Format
  Label: File Description
  Group: SrcInfo
  Data: electronic resource
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1869-4101
– Name: NoteTitleSource
  Label: Relation
  Group: SrcInfo
  Data: http://link.springer.com/article/10.1186/s13244-020-00864-9; https://doaj.org/toc/1869-4101
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1186/s13244-020-00864-9
– Name: URL
  Label: Access URL
  Group: URL
  Data: <link linkTarget="URL" linkTerm="https://doaj.org/article/a9b29d293bca4809bd8a2dabf5956ffd" linkWindow="_blank">https://doaj.org/article/a9b29d293bca4809bd8a2dabf5956ffd</link>
– Name: AN
  Label: Accession Number
  Group: ID
  Data: edsdoj.9b29d293bca4809bd8a2dabf5956ffd
PLink https://login.libproxy.scu.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&scope=site&db=edsdoj&AN=edsdoj.9b29d293bca4809bd8a2dabf5956ffd
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1186/s13244-020-00864-9
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 10
        StartPage: 1
    Subjects:
      – SubjectFull: Comprehension
        Type: general
      – SubjectFull: Diagnostic imaging
        Type: general
      – SubjectFull: Guidelines as topic
        Type: general
      – SubjectFull: Radiology
        Type: general
      – SubjectFull: Review
        Type: general
      – SubjectFull: Medical physics. Medical radiology. Nuclear medicine
        Type: general
      – SubjectFull: R895-920
        Type: general
    Titles:
      – TitleFull: Enhancing clinician and patient understanding of radiology reports: a scoping review of international guidelines
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Caitlin I. Farmer
      – PersonEntity:
          Name:
            NameFull: Allison M. Bourne
      – PersonEntity:
          Name:
            NameFull: Denise O’Connor
      – PersonEntity:
          Name:
            NameFull: Jeffrey G. Jarvik
      – PersonEntity:
          Name:
            NameFull: Rachelle Buchbinder
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 05
              Type: published
              Y: 2020
          Identifiers:
            – Type: issn-print
              Value: 18694101
          Numbering:
            – Type: volume
              Value: 11
            – Type: issue
              Value: 1
          Titles:
            – TitleFull: Insights into Imaging
              Type: main
ResultId 1