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淋巴瘤分期中的计算机断层扫描结构化报告:一项德尔菲共识提案。

Computed Tomography Structured Reporting in the Staging of Lymphoma: A Delphi Consensus Proposal.

作者信息

Granata Vincenza, Pradella Silvia, Cozzi Diletta, Fusco Roberta, Faggioni Lorenzo, Coppola Francesca, Grassi Roberta, Maggialetti Nicola, Buccicardi Duccio, Lacasella Giorgia Viola, Montella Marco, Ciaghi Eleonora, Bellifemine Francesco, De Filippo Massimo, Rengo Marco, Bortolotto Chandra, Prost Roberto, Barresi Carmelo, Cappabianca Salvatore, Brunese Luca, Neri Emanuele, Grassi Roberto, Miele Vittorio

机构信息

Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli, 80131 Naples, Italy.

Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy.

出版信息

J Clin Med. 2021 Sep 4;10(17):4007. doi: 10.3390/jcm10174007.

Abstract

Structured reporting (SR) in radiology is becoming increasingly necessary and has been recognized recently by major scientific societies. This study aims to build structured CT-based reports for lymphoma patients during the staging phase to improve communication between radiologists, members of multidisciplinary teams, and patients. A panel of expert radiologists, members of the Italian Society of Medical and Interventional Radiology (SIRM), was established. A modified Delphi process was used to develop the SR and to assess a level of agreement for all report sections. The Cronbach's alpha (Cα) correlation coefficient was used to assess internal consistency for each section and to measure quality analysis according to the average inter-item correlation. The final SR version was divided into four sections: (a) Patient Clinical Data, (b) Clinical Evaluation, (c) Imaging Protocol, and (d) Report, including = 13 items in the "Patient Clinical Data" section, = 8 items in the "Clinical Evaluation" section, = 9 items in the "Imaging Protocol" section, and = 32 items in the "Report" section. Overall, 62 items were included in the final version of the SR. A dedicated section of significant images was added as part of the report. In the first Delphi round, all sections received more than a good rating (≥3). The overall mean score of the experts and the sum of score for structured report were 4.4 (range 1-5) and 1524 (mean value of 101.6 and standard deviation of 11.8). The Cα correlation coefficient was 0.89 in the first round. In the second Delphi round, all sections received more than an excellent rating (≥4). The overall mean score of the experts and the sum of scores for structured report were 4.9 (range 3-5) and 1694 (mean value of 112.9 and standard deviation of 4.0). The Cα correlation coefficient was 0.87 in this round. The highest overall means value, highest sum of scores of the panelists, and smallest standard deviation values of the evaluations in this round reflect the increase of the internal consistency and agreement among experts in the second round compared to first round. The accurate statement of imaging data given to referring physicians is critical for patient care; the information contained affects both the decision-making process and the subsequent treatment. The radiology report is the most important source of clinical imaging information. It conveys critical information about the patient's health and the radiologist's interpretation of medical findings. It also communicates information to the referring physicians and records this information for future clinical and research use. The present SR was generated based on a multi-round consensus-building Delphi exercise and uses standardized terminology and structures, in order to adhere to diagnostic/therapeutic recommendations and facilitate enrolment in clinical trials, to reduce any ambiguity that may arise from non-conventional language, and to enable better communication between radiologists and clinicians.

摘要

放射学中的结构化报告(SR)正变得越来越必要,并且最近已得到主要科学协会的认可。本研究旨在为淋巴瘤患者在分期阶段建立基于CT的结构化报告,以改善放射科医生、多学科团队成员和患者之间的沟通。成立了一个由意大利医学与介入放射学会(SIRM)成员组成的专家放射科医生小组。采用改良的德尔菲法来制定SR并评估所有报告部分的一致程度。使用克朗巴哈系数(Cα)相关系数来评估每个部分的内部一致性,并根据平均项目间相关性来衡量质量分析。最终的SR版本分为四个部分:(a)患者临床数据,(b)临床评估,(c)成像方案,以及(d)报告,其中“患者临床数据”部分包含13项,“临床评估”部分包含8项,“成像方案”部分包含9项,“报告”部分包含32项。总体而言,SR的最终版本包含62项。作为报告的一部分,增加了一个重要图像的专用部分。在第一轮德尔菲法中,所有部分的评分都超过了良好(≥3)。专家的总体平均得分和结构化报告的得分总和分别为4.4(范围1 - 5)和1524(平均值为101.6,标准差为11.8)。第一轮的Cα相关系数为0.89。在第二轮德尔菲法中,所有部分的评分都超过了优秀(≥4)。专家的总体平均得分和结构化报告的得分总和分别为4.9(范围3 - 5)和1694(平均值为112.9,标准差为4.0)。本轮评估中最高的总体平均值、最高的专家小组得分总和以及最小的标准差反映出与第一轮相比,第二轮专家之间的内部一致性和共识有所提高。向转诊医生提供准确的影像数据陈述对于患者护理至关重要;其中包含的信息会影响决策过程和后续治疗。放射学报告是临床影像信息的最重要来源。它传达有关患者健康状况以及放射科医生对医学发现的解读的关键信息。它还向转诊医生传达信息,并记录这些信息以供未来临床和研究使用。本SR是基于多轮达成共识的德尔菲法制定的,采用标准化术语和结构,以遵循诊断/治疗建议并促进临床试验入组,减少因非传统语言可能产生的任何歧义,并实现放射科医生和临床医生之间更好的沟通。

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