Tofighi Salar, Abedi Aidin, Salehi Sana, Myers Lee, Reddy Sravanthi, Gholamrezanezhad Ali
From the Departments of Radiology.
J Patient Saf. 2021 Jun 1;17(4):e255-e261. doi: 10.1097/PTS.0000000000000653.
The aim of this study was to reach consensus on quality assessment of clinical information in imaging requisitions using Reason for exam Imaging Reporting and Data System (RI-RADS).
A Delphi study was conducted in September 2018 with a panel of 87 radiologists with diverse levels of experience from various settings (community hospitals, private hospitals, university hospitals, and clinics), of which 74.7% completed the survey. The agreement was assessed in the following subjects: (a) presumed effect of standardization, (b) the standardized system for information, (c) the scoring system for evaluation of requisitions, and (d) the implementation of RI-RADS. The consensus threshold was set at 51% responding (strongly) agree. The rate of lawsuits preventable with clinical information was also assessed.
Consensus was reached on all objectives of the study with a high level of agreement. Radiologists agreed on the need for standardization of imaging requisitions and attributed it to increased speed and accuracy of interpretations. Three categories of information were determined as key indicators of quality: impression, clinical findings, and clinical question. The scoring system is intended to grade requisitions based on the presence of these categories. Radiologists also agreed that RI-RADS will encourage physicians to improve requisitions. Among radiologists who responded to the survey, 12.6% had experienced at least one lawsuit potentially preventable with sufficient information in requisitions.
Reason for exam Imaging Reporting and Data System can be used as a standard for quality assessment of requisitions. Its use may improve the quality of patient care and reduce lawsuits against radiologists.
本研究旨在就使用检查原因影像报告和数据系统（RI-RADS）对影像检查申请单中的临床信息进行质量评估达成共识。
2018年9月对一组来自不同机构（社区医院、私立医院、大学医院和诊所）、经验水平各异的87名放射科医生进行了德尔菲研究，其中74.7%完成了调查。在以下几个方面评估了一致性：（a）标准化的假定效果，（b）信息标准化系统，（c）申请单评估评分系统，以及（d）RI-RADS的实施情况。共识阈值设定为51%的受访者（强烈）同意。还评估了可通过临床信息预防的诉讼发生率。
在研究的所有目标上均达成了高度一致的共识。放射科医生一致认为影像检查申请单需要标准化，并将其归因于解读速度和准确性的提高。确定了三类信息为质量的关键指标：印象、临床发现和临床问题。评分系统旨在根据这些类别的存在情况对申请单进行分级。放射科医生还一致认为RI-RADS将鼓励医生改进申请单。在回复调查的放射科医生中，12.6%曾经历过至少一起若申请单中有足够信息则可能可预防的诉讼。
检查原因影像报告和数据系统可作为申请单质量评估的标准。其使用可能会提高患者护理质量并减少针对放射科医生的诉讼。
