Chan Peter Y W, Kahn Charles E
Department of Radiology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
J Digit Imaging. 2019 Jun;32(3):417-419. doi: 10.1007/s10278-018-0137-0.
A lay-language glossary of radiology, built to help patients better understand the content of their radiology reports, has been analyzed for its coverage and readability, but not for its completeness. We present an iterative method to sample radiology reports, identify "missing" terms, and measure the glossary's completeness. We hypothesized that the refinement process would reduce the number of missing terms to fewer than 1 per report. A random sample of 1000 radiology reports from a large US academic health system was divided into 10 cohorts of 100 reports each. Each cohort was reviewed in sequence by two investigators to identify terms (single words and multi-word phrases) absent from the glossary. Terms marked as new were added to the glossary and hence was shown as matched in subsequent cohorts. This HIPAA-compliant study was IRB-approved; informed consent was waived. The refinement process added a mean of 288.0 new terms per 100 reports in the first 5 cohorts vs. a mean of 66.0 new terms per 100 reports in the last 5 cohorts; the difference was statistically significant (p < .01). After reviewing 500 reports, the review process found fewer than 1 new term per report in each of 500 subsequent reports. The findings suggest that 500 to 1000 reports is adequate to test the completeness of a glossary, and that the glossary after iterative refinement achieved a high level of completeness to cover the vocabulary of radiology reports.
为帮助患者更好地理解放射学报告内容而编制的一份放射学通俗语言词汇表，已针对其覆盖范围和可读性进行了分析，但未对其完整性进行分析。我们提出了一种迭代方法，用于对放射学报告进行抽样、识别“缺失”术语并衡量该词汇表的完整性。我们假设，经过完善过程，每份报告中缺失术语的数量将减少至1个以下。从美国一个大型学术医疗系统中随机抽取了1000份放射学报告，并将其分为10个队列，每个队列100份报告。两名研究人员依次对每个队列进行审查，以识别词汇表中未出现的术语（单个单词和多词短语）。标记为新术语的词汇被添加到词汇表中，因此在后续队列中显示为匹配项。这项符合《健康保险流通与责任法案》（HIPAA）的研究获得了机构审查委员会（IRB）的批准；豁免了知情同意。在前5个队列中，完善过程每100份报告平均添加288.0个新术语，而在后5个队列中，每100份报告平均添加66.0个新术语；差异具有统计学意义（p < 0.01）。在审查了500份报告之后，审查过程在随后的500份报告中每份报告发现的新术语都少于1个。研究结果表明，500至1000份报告足以测试词汇表的完整性，并且经过迭代完善后的词汇表达到了很高的完整性水平，能够涵盖放射学报告的词汇。
