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针对青少年和青年人群阑尾 CT 的结构化报告与自由文本报告:20 家医院的 594 名转诊医师、外科医生和放射科医生的偏好调查。

Structured Reporting versus Free-Text Reporting for Appendiceal Computed Tomography in Adolescents and Young Adults: Preference Survey of 594 Referring Physicians, Surgeons, and Radiologists from 20 Hospitals.

机构信息

Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.

Department of Radiology, Hallym University Sacred Heart Hospital, Anyang, Korea.

出版信息

Korean J Radiol. 2019 Feb;20(2):246-255. doi: 10.3348/kjr.2018.0109.

Abstract

OBJECTIVE

To survey care providers' preference between structured reporting (SR) and free-text reporting (FTR) for appendiceal computed tomography (CT) in adolescents and young adults.

MATERIALS AND METHODS

An ethical committee approved this prospective study. The requirement for participant consent was waived. We distributed the Likert scale-based SR form delivering the likelihood of appendicitis across 20 hospitals through a large clinical trial. In the final phase of the trial, we invited 706 potential care providers to participate in an online survey. The survey questions included usefulness in patient management, communicating the likelihood of appendicitis, convenience, style and format, and overall preference. Logistic regression analysis was performed for the overall preference. Three months after the completion of the trial, we checked if the use of the SR was sustained.

RESULTS

Responses were analyzed from 594 participants (175 attendings and 419 trainees; 225 radiologists, 207 emergency physicians, and 162 surgeons). For each question, 47.3-64.8% of the participants preferred SR, 13.1-32.7% preferred FTR, and the remaining had no preference. The overall preference varied considerably across the hospitals, but slightly across the departments or job positions. The overall preference for SR over FTR was significantly associated with attendings, SR experience for appendiceal CT, hospitals with small appendectomy volume, and hospitals enrolling more patients in the trial. Five hospitals continued using the SR in usual care after the trial.

CONCLUSION

Overall, the care providers preferred SR to FTR. Further investigation into the sustained use of the SR is needed.

摘要

目的

调查医疗保健提供者在青少年和年轻成人阑尾计算机断层扫描(CT)中对结构化报告(SR)和自由文本报告(FTR)的偏好。

材料和方法

伦理委员会批准了这项前瞻性研究。豁免了参与者同意的要求。我们通过一项大型临床试验在 20 家医院分发了基于李克特量表的 SR 表格,以提供阑尾炎的可能性。在试验的最后阶段,我们邀请了 706 名潜在的护理提供者参与在线调查。调查问题包括在患者管理中的有用性、沟通阑尾炎的可能性、便利性、风格和格式以及整体偏好。对整体偏好进行了逻辑回归分析。试验完成三个月后,我们检查了 SR 的使用是否持续。

结果

从 594 名参与者(175 名主治医生和 419 名实习医生;225 名放射科医生、207 名急诊医师和 162 名外科医生)中分析了回复。对于每个问题,47.3-64.8%的参与者更喜欢 SR,13.1-32.7%更喜欢 FTR,其余的没有偏好。医院之间的整体偏好差异很大,但科室或职位之间略有差异。与 FTR 相比,对 SR 的整体偏好与主治医生、阑尾 CT 的 SR 经验、阑尾切除术量小的医院以及参与试验的患者较多的医院显著相关。5 家医院在试验后继续在常规护理中使用 SR。

结论

总体而言,医疗保健提供者更喜欢 SR 而不是 FTR。需要进一步调查 SR 的持续使用情况。

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