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Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism

BACKGROUND: Structured reporting is an efficient and replicable method of presenting diagnostic results that eliminates variability inherent in narrative descriptive reporting and may improve clinical decisions. Synoptic element reporting can generate discrete coded data that then may inform clinica...

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Autores principales: Woller, Isabela A., Woller, Scott C., Stevens, Scott M., Lloyd, James F., Conner, Karen E., Gordon, Benjamin H., Snow, Greg L., Jones, Peter, Bledsoe, Joseph R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9530339/
https://www.ncbi.nlm.nih.gov/pubmed/36226236
http://dx.doi.org/10.1002/emp2.12801
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author Woller, Isabela A.
Woller, Scott C.
Stevens, Scott M.
Lloyd, James F.
Conner, Karen E.
Gordon, Benjamin H.
Snow, Greg L.
Jones, Peter
Bledsoe, Joseph R.
author_facet Woller, Isabela A.
Woller, Scott C.
Stevens, Scott M.
Lloyd, James F.
Conner, Karen E.
Gordon, Benjamin H.
Snow, Greg L.
Jones, Peter
Bledsoe, Joseph R.
author_sort Woller, Isabela A.
collection PubMed
description BACKGROUND: Structured reporting is an efficient and replicable method of presenting diagnostic results that eliminates variability inherent in narrative descriptive reporting and may improve clinical decisions. Synoptic element reporting can generate discrete coded data that then may inform clinical decision support and trigger downstream actions in computerized electronic health records. OBJECTIVE: Limited evidence exists for use of synoptic reporting for computed tomography pulmonary arteriography (CTPA) among patients suspected of pulmonary embolism. We reported the accuracy of synoptic reporting for the outcome of pulmonary embolism among patients who presented to an integrated health care system with CTPA performed for suspected pulmonary embolism. METHODS: Structured radiology reports with embedded synoptic elements were implemented for all CTPA examinations on March 1, 2018. Four hundred CTPA reports between January 4, 2019 and July 30, 2020 (200 reports each for which synoptic reporting recorded the presence or absence of pulmonary embolism [PE]) were selected at random. One non‐diagnostic study was excluded from analysis. We then assessed the accuracy of synoptic reporting compared with the gold standard of manual chart review. RESULTS: Synoptic reporting and manual review agreed in 99.2% of patients undergoing CTPA for suspected PE, agreed on the presence of PE in 196 of 199 (98.5%) cases, the absence of PE in 200 of 200 (100%) cases with a sensitivity of 87.6% (76.1–96.1) a specificity of 99.9% (99.7%–100%), a positive predictive value of 99.5% (98.1–100), and a negative predictive value of 98% (95.7%–99.5%). CONCLUSION: The overall rate of agreement was 99.2%, but we observed an unacceptable false‐negative rate for clinical reliance on synoptic element reporting in isolation from dictated reports.
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spelling pubmed-95303392022-10-11 Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism Woller, Isabela A. Woller, Scott C. Stevens, Scott M. Lloyd, James F. Conner, Karen E. Gordon, Benjamin H. Snow, Greg L. Jones, Peter Bledsoe, Joseph R. J Am Coll Emerg Physicians Open Imaging BACKGROUND: Structured reporting is an efficient and replicable method of presenting diagnostic results that eliminates variability inherent in narrative descriptive reporting and may improve clinical decisions. Synoptic element reporting can generate discrete coded data that then may inform clinical decision support and trigger downstream actions in computerized electronic health records. OBJECTIVE: Limited evidence exists for use of synoptic reporting for computed tomography pulmonary arteriography (CTPA) among patients suspected of pulmonary embolism. We reported the accuracy of synoptic reporting for the outcome of pulmonary embolism among patients who presented to an integrated health care system with CTPA performed for suspected pulmonary embolism. METHODS: Structured radiology reports with embedded synoptic elements were implemented for all CTPA examinations on March 1, 2018. Four hundred CTPA reports between January 4, 2019 and July 30, 2020 (200 reports each for which synoptic reporting recorded the presence or absence of pulmonary embolism [PE]) were selected at random. One non‐diagnostic study was excluded from analysis. We then assessed the accuracy of synoptic reporting compared with the gold standard of manual chart review. RESULTS: Synoptic reporting and manual review agreed in 99.2% of patients undergoing CTPA for suspected PE, agreed on the presence of PE in 196 of 199 (98.5%) cases, the absence of PE in 200 of 200 (100%) cases with a sensitivity of 87.6% (76.1–96.1) a specificity of 99.9% (99.7%–100%), a positive predictive value of 99.5% (98.1–100), and a negative predictive value of 98% (95.7%–99.5%). CONCLUSION: The overall rate of agreement was 99.2%, but we observed an unacceptable false‐negative rate for clinical reliance on synoptic element reporting in isolation from dictated reports. John Wiley and Sons Inc. 2022-10-03 /pmc/articles/PMC9530339/ /pubmed/36226236 http://dx.doi.org/10.1002/emp2.12801 Text en © 2022 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Imaging
Woller, Isabela A.
Woller, Scott C.
Stevens, Scott M.
Lloyd, James F.
Conner, Karen E.
Gordon, Benjamin H.
Snow, Greg L.
Jones, Peter
Bledsoe, Joseph R.
Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism
title Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism
title_full Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism
title_fullStr Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism
title_full_unstemmed Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism
title_short Synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism
title_sort synoptic reporting accuracy for computed tomography pulmonary arteriography among patients suspected of pulmonary embolism
topic Imaging
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9530339/
https://www.ncbi.nlm.nih.gov/pubmed/36226236
http://dx.doi.org/10.1002/emp2.12801
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