Department of Radiology, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria.
Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, ETH Zürich, Zürich, Switzerland.
Eur Radiol. 2021 Nov;31(11):8725-8732. doi: 10.1007/s00330-021-07933-7. Epub 2021 Apr 28.
We investigate in what percentage of cases and to what extent radiological reports change when radiologists directly communicate with patients after imaging examinations.
One hundred twenty-two consecutive outpatients undergoing MRI examinations at a single center were prospectively included. Radiological reports of the patients were drafted by two radiologists in consensus using only the clinical information that was made available by the referring physicians. Thereafter, one radiologist talked directly with the patient and recorded the duration of the conversation. Afterwards, the additional information from the patient was used to reevaluate the imaging studies in consensus. The radiologists determined whether the radiological report changed based on additional information and, if yes, to what extent. The degree of change was graded on a 4-point Likert scale (1, non-relevant findings, to 4, highly relevant findings).
Following direct communication (duration 170.9 ± 53.9 s), the radiological reports of 52 patients (42.6%) were changed. Of the 52 patients, the degree of change was classified as grade 1 for 8 patients (15.4 %), grade 2 for 27 patients (51.9%), grade 3 for 13 patients (25%), and grade 4 for 4 patients (7.7%). The reasons leading to changes were missing clinical information in 50 cases (96.2%) and the lack of additional external imaging in 2 cases (3.8%).
Radiologists should be aware that a lack of accurate information from the clinician can lead to incorrect radiological reports or diagnosis. Radiologists should communicate directly with patients, especially when the provided information is unclear, as it may significantly alter the radiological report.
• Direct communication between radiologists and patients for an average of 170's resulted in a change in the radiological reports of 52 patients (42.6%). • Of the 42.6% of cases where the reports were changed, the alterations were highly relevant (grades 3 and 4) in 32.7%, indicating major changes with significant impact towards patient management.
我们研究在多大比例的情况下，放射科医生在影像学检查后直接与患者沟通时，放射学报告会发生怎样的变化。
前瞻性纳入在单中心接受 MRI 检查的 122 例连续门诊患者。两名放射科医生使用仅由转诊医生提供的临床信息进行共识，起草患者的放射学报告。然后，一名放射科医生直接与患者交谈，并记录交谈的持续时间。之后，使用患者的额外信息重新评估共识下的影像学研究。放射科医生根据额外信息确定放射学报告是否发生变化，如果是，变化程度如何。变化程度在 4 分 Likert 量表上进行分级（1，无相关发现，至 4，高度相关发现）。
直接沟通（持续时间 170.9 ± 53.9 秒）后，52 名患者（42.6%）的放射学报告发生变化。在这 52 名患者中，变化程度分级为 1 级 8 例（15.4%），2 级 27 例（51.9%），3 级 13 例（25%），4 级 4 例（7.7%）。导致变化的原因是 50 例（96.2%）临床信息缺失和 2 例（3.8%）缺乏额外外部影像学。
放射科医生应该意识到，临床医生提供的信息不准确可能导致不正确的放射学报告或诊断。放射科医生应直接与患者沟通，尤其是在提供的信息不清楚时，因为这可能会显著改变放射学报告。
放射科医生与患者进行平均 170 秒的直接沟通，导致 52 名患者（42.6%）的放射学报告发生变化。
在报告发生变化的 42.6%的病例中，高度相关（3 级和 4 级）的变化占 32.7%，表明有重大变化，对患者管理有重大影响。
